Qualitative assessment of facilitators and barriers to HIV programme implementation by community health workers in Mopani district, South Africa.
South Africa has implemented a community-based HIV programme (CBHP) in its primary healthcare (PHC) re-engineering strategy that aims to improve public healthcare delivery. This CBHP is delivered by ward-based outreach teams (WBOTs); provision of community HIV services comprises an important compone...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2018-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0203081 |
| _version_ | 1818682561899003904 |
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| author | Nireshni Naidoo Nkosinathi Zuma N Sellina Khosa Gert Marincowitz Jean Railton Nthabiseng Matlakala Geoffrey A Jobson Jude O Igumbor James A McIntyre Helen E Struthers Remco P H Peters |
| author_facet | Nireshni Naidoo Nkosinathi Zuma N Sellina Khosa Gert Marincowitz Jean Railton Nthabiseng Matlakala Geoffrey A Jobson Jude O Igumbor James A McIntyre Helen E Struthers Remco P H Peters |
| author_sort | Nireshni Naidoo |
| collection | DOAJ |
| description | South Africa has implemented a community-based HIV programme (CBHP) in its primary healthcare (PHC) re-engineering strategy that aims to improve public healthcare delivery. This CBHP is delivered by ward-based outreach teams (WBOTs); provision of community HIV services comprises an important component of this programme. We conducted an exploratory study to determine the facilitators and barriers to successful implementation of this CBHP in rural Mopani District, South Africa. Focus group discussions were conducted with the community health workers (CHWs) and PHC nurses; participant interviews were conducted with community members who access these health services, community leaders, and social workers. We conducted a thematic content analysis and based on the key themes reported, we identified the Consolidated Framework for Implementation Research, consisting of five domains, as the most appropriate model to interpret our findings. First, in terms of intervention characteristics, community members generally valued the HIV services provided, but the variable needs impacted on programme implementation. Outer setting challenges include inability to meet the need of patients as a result of stigma, non-disclosure of HIV status and social factors. In terms of the inner setting, CHWs were grateful for the equipment and training received but expressed the need for better support of management and the provision of additional resources. With regard to characteristics of the implementers, the CHWs expressed the desire for further training despite reporting having sufficient knowledge to conduct their HIV work. Finally, in terms of the implementation process, the importance of relationship building between CHWs and community members was emphasised. In conclusion, these data underline the positive receipt and potential of the CBHP in this rural district and identify areas to further strengthen the programme. The success and sustainability of the CBHP requires ongoing commitment of resources, training, supervision, and organisational support in order to operate effectively and efficiently. |
| first_indexed | 2024-12-17T10:20:48Z |
| format | Article |
| id | doaj.art-6f30df0f8ab94a7798d01382d6f3892f |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-17T10:20:48Z |
| publishDate | 2018-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-6f30df0f8ab94a7798d01382d6f3892f2022-12-21T21:52:48ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01138e020308110.1371/journal.pone.0203081Qualitative assessment of facilitators and barriers to HIV programme implementation by community health workers in Mopani district, South Africa.Nireshni NaidooNkosinathi ZumaN Sellina KhosaGert MarincowitzJean RailtonNthabiseng MatlakalaGeoffrey A JobsonJude O IgumborJames A McIntyreHelen E StruthersRemco P H PetersSouth Africa has implemented a community-based HIV programme (CBHP) in its primary healthcare (PHC) re-engineering strategy that aims to improve public healthcare delivery. This CBHP is delivered by ward-based outreach teams (WBOTs); provision of community HIV services comprises an important component of this programme. We conducted an exploratory study to determine the facilitators and barriers to successful implementation of this CBHP in rural Mopani District, South Africa. Focus group discussions were conducted with the community health workers (CHWs) and PHC nurses; participant interviews were conducted with community members who access these health services, community leaders, and social workers. We conducted a thematic content analysis and based on the key themes reported, we identified the Consolidated Framework for Implementation Research, consisting of five domains, as the most appropriate model to interpret our findings. First, in terms of intervention characteristics, community members generally valued the HIV services provided, but the variable needs impacted on programme implementation. Outer setting challenges include inability to meet the need of patients as a result of stigma, non-disclosure of HIV status and social factors. In terms of the inner setting, CHWs were grateful for the equipment and training received but expressed the need for better support of management and the provision of additional resources. With regard to characteristics of the implementers, the CHWs expressed the desire for further training despite reporting having sufficient knowledge to conduct their HIV work. Finally, in terms of the implementation process, the importance of relationship building between CHWs and community members was emphasised. In conclusion, these data underline the positive receipt and potential of the CBHP in this rural district and identify areas to further strengthen the programme. The success and sustainability of the CBHP requires ongoing commitment of resources, training, supervision, and organisational support in order to operate effectively and efficiently.https://doi.org/10.1371/journal.pone.0203081 |
| spellingShingle | Nireshni Naidoo Nkosinathi Zuma N Sellina Khosa Gert Marincowitz Jean Railton Nthabiseng Matlakala Geoffrey A Jobson Jude O Igumbor James A McIntyre Helen E Struthers Remco P H Peters Qualitative assessment of facilitators and barriers to HIV programme implementation by community health workers in Mopani district, South Africa. PLoS ONE |
| title | Qualitative assessment of facilitators and barriers to HIV programme implementation by community health workers in Mopani district, South Africa. |
| title_full | Qualitative assessment of facilitators and barriers to HIV programme implementation by community health workers in Mopani district, South Africa. |
| title_fullStr | Qualitative assessment of facilitators and barriers to HIV programme implementation by community health workers in Mopani district, South Africa. |
| title_full_unstemmed | Qualitative assessment of facilitators and barriers to HIV programme implementation by community health workers in Mopani district, South Africa. |
| title_short | Qualitative assessment of facilitators and barriers to HIV programme implementation by community health workers in Mopani district, South Africa. |
| title_sort | qualitative assessment of facilitators and barriers to hiv programme implementation by community health workers in mopani district south africa |
| url | https://doi.org/10.1371/journal.pone.0203081 |
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