Browsing by Author "Maronda, Peris Muthoni Gichuhi"
Now showing 1 - 1 of 1
Results Per Page
Sort Options
- ItemThe experiences of NIMART-trained nurses providing care to children living with HIV at ART clinics in the Windhoek District of Namibia(Stellenbosch : Stellenbosch University, 2021-12) Maronda, Peris Muthoni Gichuhi; Eygelaar, Elsa; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.ENGLISH SUMMARY : Background: Globally, an increase in the number of children living with the Human Immunodeficiency Virus (HIV) has been observed. This is a result of the expanded antiretroviral therapy (ART) coverage. Most of these children live in sub-Saharan Africa, a region that has scarcity of healthcare human resources. Task shifting was introduced as a means to increase access to ART and HIV related health- care services. Nurses trained in the initiation and management of ART (NIMART) have become an integral part of the paediatric HIV/AIDS response workforce through task shifting and decentralisation of services strategies. There is scarcity of information regarding the experiences of NIMART-trained nurses providing care to paediatric ART patients in Windhoek District of Namibia. Aim The aim of this study was to explore the experiences of NIMART-trained nurses providing care to children living with HIV at ART clinics in the Windhoek District of Namibia. Objectives: To explore the experiences of NIMART-trained nurses regarding individual, interpersonal, institutional, community and policy factors and how these affect the provision of paediatric HIV care. Population and study setting: The target population was all (25) NIMART-trained nurses practising paediatric ART in health facilities within the Windhoek District. The accessible population were 16 NIMART- trained nurses practicing within the three selected facilities within Windhoek district. The study was conducted in 3 of the 14 public health facilities in the Windhoek District of Namibia, namely Katutura State Hospital, Katutura Health Centre, and Otjomuise Clinic. The three facilities were purposively selected to represent a hospital setting, a health centre setting and a clinic setting. These three facilities also had the highest number of paediatric ART patients among the categories of health care settings they represented. Methods: This study applied an exploratory-descriptive qualitative approach which aimed at gaining in-depth knowledge and understanding of the experiences of NIMART-trained nurses providing paediatric ART care. Data was collected by the researcher and a study assistant using semi-structured individual in-depth interviews (face to face). Twelve (12) participants, including a pilot interview participant, were interviewed. Data was analysed using content analysis. Ethics approval was obtained from the Stellenbosch University Health Research Ethics Committee and the Namibia Ministry of Health and Social Services Research Ethics Committee. Permission to conduct the study was also obtained from the Khomas Region Health Directorate, and the Medical Superintendent of Katutura State Hospital. Results: The five themes that emerged were aligned to the objectives of the study: experiences related to individual factors, experiences related to interpersonal factors, experiences related to institutional factors, experiences related to community factors, and experiences related to policy factors. In general, the NIMART-trained nurses expressed both positive and negative experiences in their provision of paediatric ART services. The positive experiences related to empowerment of the nurses, improved self-esteem, job satisfaction and perceived reduction of new HIV infection among the infants exposed to HIV. The negative experiences emanated from inadequate paediatric ART knowledge and skills, increased workload and staff shortages, lack of teamwork, inadequate supervision and mentoring, lack of support from caregivers, and lack of resources, and poor socioeconomic backgrounds of the paediatric patients. Conclusion and recommendation: Task shifting has brought paediatric ART initiation and management into the practice of NIMART-trained nurses. Therefore, it is necessary that the nurses are equipped with knowledge and skills vital for this role. In addition, supervisory and mentoring support is necessary to help improve their confidence in managing paediatric ART patients. The healthcare system should also focus on dealing with barriers such as material, infrastructural and material resources that hinder effective provision of paediatric ART services by NIMART-trained nurses.