Registered nurses' experiences regarding operational factors influencing the implementation of HIV care services in the mobile health clinics of eThekwini Municipality in KwaZulu-Natal

Silingene Joyce Ngcobo; Lufuno Makhado; Leepile Alfred Sehularo

doi:10.1186/s12912-024-01764-9

Registered nurses' experiences regarding operational factors influencing the implementation of HIV care services in the mobile health clinics of eThekwini Municipality in KwaZulu-Natal

BMC Nurs. 2024 Feb 6;23(1):102. doi: 10.1186/s12912-024-01764-9.

Authors

Silingene Joyce Ngcobo^{1

2}, Lufuno Makhado³, Leepile Alfred Sehularo⁴

Affiliations

¹ Lifestyle Diseases Research Focus Area, Faculty of Health Sciences, North-West University, Mmabatho, South Africa. Ngcobos5@ukzn.ac.za.
² School of Nursing and Public Health, College Health Sciences, University of KwaZulu Natal, Durban, South Africa. Ngcobos5@ukzn.ac.za.
³ Department of Public Health, Faculty of Health Sciences, University of Venda, Thohoyandou, South Africa.
⁴ Lifestyle Diseases Research Focus Area, Faculty of Health Sciences, North-West University, Mmabatho, South Africa.

Abstract

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.

Keywords: Community-based clinics; Decentralised HIV care; HIV care; Mobile health clinics; NIMART implementation; Nurses; Operational factors.