Study Objective
The objectives of this study are:
(1) to explore the impact of the national consolidated guidelines for Option B+ PMTCT on the work of healthcare professionals at both clinical and management levels (including nurses, physicians and management)
(2) to understand pregnant HIV-positive women views and experiences with ART for life, as a way to better manage the Option B+ PMTCT programme within state hospitals
Research Questions
The following research questions will be used to explore both perceptions of healthcare professionals and patients:
1.How have the national consolidated guidelines for Option B+ PMTCT affected the work of healthcare professionals?
2.What are pregnant HIV-positive women’s views and experiences about going on lifetime treatment with ARVs? / ABSTRACT
Background. South Africa’s National Department of Health has adopted World Health Organization’s (WHO) 2013 consolidated guidelines on the use of ARVs for treatment and prevention of HIV infection. The guidelines include changes for prevention of mother to child transmission (PMTCT) through Option B+. Option B+ aims to reduce the HIV prevalence rate amongst these women by placing them on ART for life, no matter their CD4 count. As a result, in January 2015, these guidelines were implemented for the PMTCT programme at RMMCH. Little is known about the impact of these new guidelines on the work of healthcare professionals in state hospitals. Most importantly, no research has focused on how these changes have affected adherence for the patients.
Purpose. The purpose of this research project is (1) to explore the impact of the Option B+ PMTCT programme on the work of healthcare professionals, and (2) to understand pregnant HIV-positive women views and experiences with ART for life, as a way to better manage the Option B+ PMTCT programme.
Methods. A qualitative study design is used with a phenomenological approach. The methodology uses demographic questionnaires and semi-structured interviews with healthcare professionals and patients. The study is situated in Johannesburg, South Africa.
Findings. The findings demonstrate that work has changed and become difficult to manage for all healthcare professionals because of (1) the need for strengthening indicators for tracking to decrease loss to follow-up (LTFU); (2) inconsistency in delivery of counseling and support services and the need for communication across clinical departments; and (3) the lack of compassion and understanding by service providers. The difficult healthcare environment has affected overall views and experiences of pregnant HIV-positive women going on ART for life. All 55 patient participants responded that they chose to take the fixed-dose combination (FDC) for life to protect the health of the baby and felt ART for life can be stopped after giving birth.
Conclusion. Implications for future research include the need to address changes within the healthcare system at both clinical and management levels. It is crucial to incorporate the perspective of patients in policy implementation; uptake and adherence are key indicators in informing whether the Option B+ PMTCT programme is being adapted into state hospitals effectively. There needs to be extensive research on how to strengthen indicators for long term scalability and sustainability of the programme. Future evaluations need to address, will interdisciplinary collaboration within hospitals improve the management and understanding of Option B+? / Thesis / Master of Science (MSc)
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/18348 |
| Date | 22 November 2015 |
| Creators | Bisnauth, Melanie A. |
| Contributors | Birch, Stephen, Coovadia, Ashraf, Wilson, Michael G., Mbuagbaw, Lawrence, Global Health |
| Source Sets | McMaster University |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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