Building capacity for antiretroviral delivery in South Africa: A qualitative evaluation of the PALSA PLUS nurse training programme

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dc.contributor.authorStein, Jen_ZA
dc.contributor.authorLewin, Sen_ZA
dc.contributor.authorFairall, Len_ZA
dc.contributor.authorMayers, Pen_ZA
dc.contributor.authorEnglish, Ren_ZA
dc.contributor.authorBheekie, Aen_ZA
dc.contributor.authorBateman, Een_ZA
dc.contributor.authorZwarenstein, Men_ZA
dc.date.accessioned2015-10-28T06:53:11Z
dc.date.available2015-10-28T06:53:11Z
dc.date.issued2008en_ZA
dc.description.abstractBACKGROUND: South Africa recently launched a national antiretroviral treatment programme. This has created an urgent need for nurse-training in antiretroviral treatment (ART) delivery. The PALSA PLUS programme provides guidelines and training for primary health care (PHC) nurses in the management of adult lung diseases and HIV/AIDS, including ART. A process evaluation was undertaken to document the training, explore perceptions regarding the value of the training, and compare the PALSA PLUS training approach (used at intervention sites) with the provincial training model. The evaluation was conducted alongside a randomized controlled trial measuring the effects of the PALSA PLUS nurse-training (Trial reference number ISRCTN24820584). METHODS: Qualitative methods were utilized, including participant observation of training sessions, focus group discussions and interviews. Data were analyzed thematically. RESULTS: Nurse uptake of PALSA PLUS training, with regard not only to ART specific components but also lung health, was high. The ongoing on-site training of all PHC nurses, as opposed to the once-off centralized training provided for ART nurses only at non-intervention clinics, enhanced nurses' experience of support for their work by allowing, not only for ongoing experiential learning, supervision and emotional support, but also for the ongoing managerial review of all those infrastructural and system-level changes required to facilitate health provider behaviour change and guideline implementation. The training of all PHC nurses in PALSA PLUS guideline use, as opposed to ART nurses only, was also perceived to better facilitate the integration of AIDS care within the clinic context. CONCLUSION: PALSA PLUS training successfully engaged all PHC nurses in a comprehensive approach to a range of illnesses affecting both HIV positive and negative patients. PHC nurse-training for integrated systems-based interventions should be prioritized on the ART funding agenda. Training for individual provider behaviour change is nonetheless only one aspect of the ongoing system-wide interventions required to effect lasting improvements in patient care in the context of an over-burdened and under-resourced PHC system.en_ZA
dc.identifier.apacitationStein, J., Lewin, S., Fairall, L., Mayers, P., English, R., Bheekie, A., ... Zwarenstein, M. (2008). Building capacity for antiretroviral delivery in South Africa: A qualitative evaluation of the PALSA PLUS nurse training programme. <i>BMC Health Services Research</i>, http://hdl.handle.net/11427/14434en_ZA
dc.identifier.chicagocitationStein, J, S Lewin, L Fairall, P Mayers, R English, A Bheekie, E Bateman, and M Zwarenstein "Building capacity for antiretroviral delivery in South Africa: A qualitative evaluation of the PALSA PLUS nurse training programme." <i>BMC Health Services Research</i> (2008) http://hdl.handle.net/11427/14434en_ZA
dc.identifier.citationStein, J., Lewin, S., Fairall, L., Mayers, P., English, R., Bheekie, A., ... & Zwarenstein, M. (2008). Building capacity for antiretroviral delivery in South Africa: a qualitative evaluation of the PALSA PLUS nurse training programme. BMC Health Services Research, 8(1), 240.en_ZA
dc.identifier.ris TY - Journal Article AU - Stein, J AU - Lewin, S AU - Fairall, L AU - Mayers, P AU - English, R AU - Bheekie, A AU - Bateman, E AU - Zwarenstein, M AB - BACKGROUND: South Africa recently launched a national antiretroviral treatment programme. This has created an urgent need for nurse-training in antiretroviral treatment (ART) delivery. The PALSA PLUS programme provides guidelines and training for primary health care (PHC) nurses in the management of adult lung diseases and HIV/AIDS, including ART. A process evaluation was undertaken to document the training, explore perceptions regarding the value of the training, and compare the PALSA PLUS training approach (used at intervention sites) with the provincial training model. The evaluation was conducted alongside a randomized controlled trial measuring the effects of the PALSA PLUS nurse-training (Trial reference number ISRCTN24820584). METHODS: Qualitative methods were utilized, including participant observation of training sessions, focus group discussions and interviews. Data were analyzed thematically. RESULTS: Nurse uptake of PALSA PLUS training, with regard not only to ART specific components but also lung health, was high. The ongoing on-site training of all PHC nurses, as opposed to the once-off centralized training provided for ART nurses only at non-intervention clinics, enhanced nurses' experience of support for their work by allowing, not only for ongoing experiential learning, supervision and emotional support, but also for the ongoing managerial review of all those infrastructural and system-level changes required to facilitate health provider behaviour change and guideline implementation. The training of all PHC nurses in PALSA PLUS guideline use, as opposed to ART nurses only, was also perceived to better facilitate the integration of AIDS care within the clinic context. CONCLUSION: PALSA PLUS training successfully engaged all PHC nurses in a comprehensive approach to a range of illnesses affecting both HIV positive and negative patients. PHC nurse-training for integrated systems-based interventions should be prioritized on the ART funding agenda. Training for individual provider behaviour change is nonetheless only one aspect of the ongoing system-wide interventions required to effect lasting improvements in patient care in the context of an over-burdened and under-resourced PHC system. DA - 2008 DB - OpenUCT DO - 10.1186/1472-6963-8-240 DP - University of Cape Town J1 - BMC Health Services Research LK - https://open.uct.ac.za PB - University of Cape Town PY - 2008 T1 - Building capacity for antiretroviral delivery in South Africa: A qualitative evaluation of the PALSA PLUS nurse training programme TI - Building capacity for antiretroviral delivery in South Africa: A qualitative evaluation of the PALSA PLUS nurse training programme UR - http://hdl.handle.net/11427/14434 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/14434
dc.identifier.urihttp://dx.doi.org/10.1186/1472-6963-8-240
dc.identifier.vancouvercitationStein J, Lewin S, Fairall L, Mayers P, English R, Bheekie A, et al. Building capacity for antiretroviral delivery in South Africa: A qualitative evaluation of the PALSA PLUS nurse training programme. BMC Health Services Research. 2008; http://hdl.handle.net/11427/14434.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentDivision of Pulmonologyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2008 Stein et al; licensee BioMed Central Ltd.en_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceBMC Health Services Researchen_ZA
dc.source.urihttp://www.biomedcentral.com/bmchealthservres/en_ZA
dc.subject.otherAnti-Retroviral Agentsen_ZA
dc.subject.otherEducation, Nursing, Continuingen_ZA
dc.subject.otherHIV Infectionsen_ZA
dc.subject.otherPublic Health Nursingen_ZA
dc.titleBuilding capacity for antiretroviral delivery in South Africa: A qualitative evaluation of the PALSA PLUS nurse training programmeen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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