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Browsing Articles by Subject "Community-based clinics"

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    Managerial factors influencing the implementation of NIMART services in the mobile health clinics of eThekwini municipality in KwaZulu-Natal
    (Elsevier, 2024) Ngcobo, Silingene Joyce; Makhado, Lufuno; Sehlularo, Leepile Alfred
    Background The mobile health clinics (MHCs) have been instrumental in rolling out Human Immunodeficiency Virus (HIV) care since they are an extension of Primary Health Care (PHC) services. The integration of HIV care into PHC services is reported as a structural facilitative factor for implementing nurse-initiated antiretroviral therapy (NIMART). The success of any health program relies heavily on management and support structure, hence managers’ perspectives on the implementation of NIMART services in MHCs are deemed crucial. Aim The study aimed to explore and describe the managerial factors influencing the implementation of NIMART services in the MHCs of eThekwini municipality in KwaZulu Natal. Methods A generic qualitative research approach was used applying Qualitative Exploratory Descriptive (QED) design, on twelve MHC managers who were purposefully selected and managing MHCs operated by local and provincial health authorities. The study was approved by the North-West University Human Research Ethics Committee (NWU 00934–19-A1), provincial (KZ_202002_017) and local health (30/1/1/6/3/1) authorities. Online semi-structured interviews were conducted to collect data and were transcribed. Atlas-TI was used for data analysis while demographic data was descriptively analysed. Results Three themes and twelve subthemes emerged from the study: theme 1: Challenges in implementing NIMART services in MHCs, theme 2: Positive factors influencing implementation of NIMART services in MHCs, and theme 3: Suggestions to strengthen implementation of NIMART services. Subthemes were shortage of staff, shortage of medical equipment for NIMART services, challenges with infrastructure, lack of budget for NIMART services, nurses are trained in NIMART, continuous meetings, Proper planning, more nurses should be trained on NIMART, employment of more nursing personnel, collaboration with relevant stakeholders, proper infrastructure for NIMART and need for allowances. Conclusion The involvement of managers is key to the successful implementation of NIMART services in the MHCs and improvement is more desirable.
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    Registered nurses’ experiences regarding operational factors influencing the implementation of HIV care services in the mobile health clinics of eThekwini Municipality in KwaZulu-Natal
    (Springer Nature, 2024) Ngcobo, Silingene Joyce; Makhado, Lufuno; Sehularo, Leepile Alfred
    Background Registered nurses working in the mobile health clinics (MHCs) play an important role in enabling HIV care access to populations in remote areas through Nurse Initiated Antiretroviral Therapy program (NIMART). Aim To explore and describe the nurses’ experiences regarding operational factors influencing the implementation of HIV care services in the mobile health clinics (MHCs) of eThekwini Municipality in KwaZulu Natal. Methods Qualitative Exploratory Descriptive (QED) method was used after permission was granted from North-West University Human Research Ethics Committee provincial and local health authorities. Data saturation informed sample size of thirteen MHCs nurses were purposefully sampled to participate. Audio-recorded, semi-structured, online, one-on-one interviews guided by open-ended questions were done for data collection, and including demographic profile. The interview transcripts were analysed using Atlas-TI and SPSS descriptive statistics was used for demographics. Results Eleven subthemes emerged under patient-related, nurse-related, and organisational-related themes which influence the operational factors in the MHCs, namely: patient defaulting treatment, lack of privacy, unavailability of phones, stressful and demotivating MHCs, nurses feel unsafe, lack of support from management, lack of budget, unavailability of computers, shortage of medical equipment, shortage of nursing staff and absence of data capturers. Conclusion Structured contextual coaching and support program for nurses is imperative to ensure effective and strengthened operations in MHCs, further supported by improvement in human resource for health allocation for MHCs in light of expanding health care programs Contributions Evaluation of health care programmes, and human resource for health quality improvement needs in the clinical practice of HIV care of MHCs nurses which advocate for specific policy formulations.