Factors contributing to attrition from the medication dispensing programme in the North West Province amongst people living with HIV

Abstract

The Centralised Chronic Medicine Dispensing and Distribution (CCMDD) programme, introduced in South Africa in 2014, works in partnership with the Health Systems Trust (HST) on behalf of the National Department of Health. The aim of the programme is to provide access to stable HIV- infected clients to receive treatment outside of the clinic at pick up points with shorter queues in a convenient area. This study intended to explore and describe the factors that contribute to the attrition rate amongst people living with Human Immunodeficiency Virus (HIV) from the CCMDD programme in the Bojanala District, Northwest Province. A qualitative, explorative, and descriptive approach guided the study. Twelve people living with HIV were purposively sampled and individual interviews were conducted until data saturation was reached. Data analysis was done using content analysis. Three main themes emerged from the data, namely patient-related factors, healthcare provider-related factors and resource-related factors, with sub-themes such as financial challenges, patient-nurse interaction, stigmatization, and inadequate knowledge of ARV therapy; resource provider-related issues like medication availability and inconvenient collection periods, addressing these factors is crucial to improving retention in the programme. Results: The factors emerged indicated the need for strategies to address financial support for patients, community education to reduce stigmatization, and enhanced patient educationon ARV therapy. Strengthening patient-nurse interactions and ensuring consistent follow-up from the healthcare providers are also essential. Recommendations include ensuring reliable medication availability and flexible collection periods to accommodate patients’ schedules.