Exploring the views of nurses regarding the implementation of differentiated care for patients receiving antiretroviral treatment

Abstract

Introduction South Africa has made significant progress in improving the provision of care for HIV-positive patients. With approximately four million people on Anti-retroviral therapy (ART), the country is faced with a congestion of patients at primary health care facilities. The differentiated care strategy was adopted from the World Health Organisation (WHO) in 2016 and it encompasses the whole of the HIV (Human Immunodeficiency Virus) treatment and care continuum. Differentiated care is a client-centred approach that ensures that HIV services across the continuum of care reflect the preferences and expectations of People Living with HIV (PLHIV), while reducing the HIV burden on primary health care facilities. The strategy is aimed at reducing congestion of patients at facilities so that health workers can pay more attention to patients who are in the most need of care. Aim To explore and describe the views of nurses regarding the implementation of differentiated care for patients receiving antiretroviral treatment. Research design A qualitative, descriptive, and explorative design has been used to explore and describe the views of nurses regarding the implementation of differentiated care. Methods Semi-structured interviews were used to collect data from nurses implementing differentiated care for stable ART patients in the Tshwane Health Sub- district. Twenty registered nurses were sampled across the Tshwane sub district. One-on-one interviews were conducted. One open-ended question was asked, and the researcher used probing questions to reach an in-depth comprehension of the views of nurses regarding differentiated care. Interviews continued until data saturation was met at 14 participants but extended to 16 participants to ensure no information was missed. The researcher then transcribed data accurately and developed a category of schemes. Information was coded by the researcher and co-coded by an expert coder to arrive at an accurate analysis of the data gathered. Results of the study The study reveals that differentiated care has reduced patients’ waiting times, reduced staff workload and congestion at primary health care facilities. Challenges impacting on differentiated care are mentioned and recommendations for improvement made by nurses implementing the strategy. Conclusion According to the results of the study, differentiated care is viewed by nurses as a strategy that is beneficial to both the patients and the health care workers. Keywords: Antiretroviral treatment, Differentiated Care, HIV Continuum, Primary Health Care, South Africa, Views