Community healthcare workers´ experiences with the care of clients on antiretroviral therapy in the community

Abstract

Introduction: community healthcare workers are members of the community affiliated with community-based organisations to implement Primary Health Care (PHC) in the district health services of South Africa. Among other roles, they are expected to care for clients on antiretroviral therapy (ART) in the community. The purpose of this study was to explore how community healthcare workers describe their experience regarding the management of ART clients in the community environment.

Methods: a qualitative phenomenological approach was used. Semistructured focus group discussion, observations, and document analysis were conducted with 39 community healthcare workers who had ART clients in their register. Inductive coding was used to determine invariant constituents, reduce constituents to categories, and cluster categories into themes. Reliability and validity were accomplished through intercoder agreement, audio recording, triangulation, bracketing, and member checking.

Results: results identified five core themes related to what community healthcare workers experience during the management of HIV clients in the community environment. They explained a wide-ranging insight into their experiences in providing care to ART clients. They described a number of concerning situations that included meaningful roles, feelings about the clients´ engagement, clients´ improper linkage to care, perceived barriers and perceived influences.

Conclusion: several challenges were encountered by community healthcare workers while implementing the HIV programme in the community. The study saw the need for health departmental awareness for community acceptance of community healthcare workers work. This will thus impact positively in community healthcare workers programmes and thus improving the provision of primary health care services particularly in HIV programme.