Registered nurses’ perceptions regarding nurse-led antiretroviral therapy initiation in Hhohho region, Swaziland

Abstract

Background: Swaziland has the highest HIV prevalence globally. It faces a critical shortage of health workers for addressing the HIV pandemic. To curb this human resource challenge, Swaziland adopted a nurse-driven model for antiretroviral therapy delivery in line with the recommendations of the World Health Organization on task shifting. Objective: The study explored the perceptions of registered nurses on the nurse-led antiretroviral therapy initiation programme in the Hhohho region of Swaziland (NARTIS). Design: The study utilized a phenomenological design, specifically a phenomenographic design. Setting: The study was conducted in ten health facilities in the Hhohho region of Swaziland. These facilities comprised eight clinics, a hospital and a health centre. Participants: These were registered nurses, trained and certified in the nurse-led antiretroviral therapy initiation programme. The nurses also had experience of working in a nurse-led antiretroviral therapy initiation programme. Eighteen (18) nurses were purposively selected and recruited to participate in the study. Methods: Data were collected through open and deep individual interviews guided by a semi-structured interview schedule. The audio-recorded interviews were transcribed and analysed thematically using Sj€ostr€om and Dahlgren’s approach to data analysis. Results: Three major themes emerged from the study data: nurses’ emotional reactions to the implementation of the NARTIS programme, and influences and overcoming barriers to the programme. Conclusions: The study findings have generated insights into this program which is useful for the provision of care to people living with HIV/AIDS in Swaziland. But nurses need support to ensure effective implementation. Implication for nursing and health policy: The study findings have implications for both the practice of the NARTIS programme and health policy development. The development of a health policy that alleviates the barriers to the NARTIS programme can enhance nurses’ role and make care provision to people living with HIV/AIDS more effective.