Browsing by Author "Mabandla, Mamoferefere Tatapa Zim"

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    Adolescent-friendly services : experiences of adolescents living with HIV attending healthcare services in Botha-Bothe District in Lesotho
    (Stellenbosch : Stellenbosch University, 2020-03) Mabandla, Mamoferefere Tatapa Zim; Crowley, Talitha; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.
    ENGLISH SUMMARY : There is an increased focus on the promotion of health and wellbeing amongst adolescents. Adolescents living with HIV (ALHIV) need to access high-quality and comprehensive health services. Adolescent-friendly services are services which are easy to reach, are appealing, and are delivered in acceptable ways to adolescents, to meet their health needs. Considering the health of adolescents, the need for adolescent-friendly services was identified, to lessen the load of diseases and to decrease the number of deaths that occur amongst adolescents. The adolescent HIV burden is still a concern and countries are struggling to establish interventions that are effective for positively influencing HIV related outcomes in this group. There are few studies on the experiences of ALHIV about accessing health services in different countries and various health facilities. Little is known about adolescent-friendly services for ALHIV in the context of Lesotho. Aim: The study aimed to explore and to describe the experiences of ALHIV regarding attending healthcare services in Botha-Bothe District Lesotho, in order to make recommendations towards improving adolescent-friendly services. Method: A qualitative exploratory-descriptive research design was applied. The Health Research Ethics Committee (HREC) from Stellenbosch University and the Research Coordinating Unit (RCU) from the Lesotho Ministry of Health approved the study. Twelve ALHIV between the ages of fourteen (14) and nineteen (19), who were attending healthcare services at Baylor or Ngoajane health facilities and were aware of their HIV status, were purposively selected to participate in the study. For adolescents under eighteen (18) years old, written informed adolescent assent and parental consent was obtained. Written informed consent was obtained from adolescents aged between eighteen and nineteen (18 and 19). Individual interviews were conducted by the researcher. The six steps of data analysis described by Creswell were applied when analysing the data. The researcher ensured trustworthiness by adhering to the principles of confirmability, transferability, credibility and dependability. Results: Five themes were identified: the social environment of the health facility, the physical environment of the health facility, services, support and expectations regarding healthcare services. Communication between the participants and the healthcare workers was challenging. It seemed that it was difficult to communicate effectively because of the generation gap and the adolescent stage of development. Healthcare workers were more likely to communicate in a consistent respectful manner if adolescents were adherent to treatment and care. Health facilities do not have a dedicated space to allow adolescents to interact with peers and share their experiences. Services that adolescents use in the facilities are counseling and HIV care and treatment. Family members seemed to be involved minimally in the care and in the treatment of adolescents. Adolescents prefer services to be provided on a Friday after school, or on a Saturday when they are not attending school. Conclusion: ALHIV need to access comprehensive adolescent-friendly services, as this may improve their health outcomes. The elements of adolescent-friendly services that could be improved include providing a dedicated space, the provision of ageappropriate educational materials, encouraging care partnerships and the training of healthcare workers to ensure technical and attitudinal competences, in providing healthcare services to adolescents.