Integrating HIV care into nurse-led primary health care services in South Africa: a synthesis of three linked qualitative studies

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dc.contributor.authorUebel, Kerryen_ZA
dc.contributor.authorGuise, Andyen_ZA
dc.contributor.authorGeorgeu, Daniellaen_ZA
dc.contributor.authorColvin, Christopheren_ZA
dc.contributor.authorLewin, Simonen_ZA
dc.date.accessioned2015-11-23T12:10:17Z
dc.date.available2015-11-23T12:10:17Z
dc.date.issued2013en_ZA
dc.description.abstractBACKGROUND: The integration of HIV care into primary care services is one of the strategies proposed to increase access to treatment for people living with HIV/AIDS in high HIV burden countries. However, how best to do this is poorly understood. This study documents different factors influencing models of integration within clinics. METHODS: Using methods based on the meta-ethnographic approach, we synthesised the findings from three qualitative studies of the factors that influenced integration of HIV care into all consultations in primary care. The studies were conducted amongst staff and patients in South Africa during a randomised trial of nurse initiation of antiretroviral therapy (ART) and integration of HIV care into primary care services - the Streamlining Tasks and Roles to Expand Treatment and Care for HIV (STRETCH) trial. Themes from each study were identified and translated into each other to develop categories and sub-categories and then to inform higher level interpretations of the synthesised data. RESULTS: Clinics varied as to how HIV care was integrated. Existing administration systems, workload and support staff shortages tended to hinder integration. Nurses' wanted to be involved in providing HIV care and yet also expressed preferences for developing expertise in certain areas and for establishing good nurse patient relationships by specialising in certain services. Patients, in turn, were concerned about the stigma of separate HIV services and yet preferred to be seen by nurses with expertise in HIV care. These factors had conflicting effects on efforts to integrate HIV care. CONCLUSION: Local clinic factors and nurse and patient preferences in relation to care delivery should be taken into account in programmes to integrate HIV care into primary care services. The integration of medical records, monitoring and reporting systems would support clinic based efforts to integrate HIV care into primary care services.en_ZA
dc.identifier.apacitationUebel, K., Guise, A., Georgeu, D., Colvin, C., & Lewin, S. (2013). Integrating HIV care into nurse-led primary health care services in South Africa: a synthesis of three linked qualitative studies. <i>BMC Health Services Research</i>, http://hdl.handle.net/11427/15261en_ZA
dc.identifier.chicagocitationUebel, Kerry, Andy Guise, Daniella Georgeu, Christopher Colvin, and Simon Lewin "Integrating HIV care into nurse-led primary health care services in South Africa: a synthesis of three linked qualitative studies." <i>BMC Health Services Research</i> (2013) http://hdl.handle.net/11427/15261en_ZA
dc.identifier.citationUebel, K., Guise, A., Georgeu, D., Colvin, C., & Lewin, S. (2013). Integrating HIV care into nurse-led primary health care services in South Africa: a synthesis of three linked qualitative studies. BMC health services research, 13(1), 171.en_ZA
dc.identifier.ris TY - Journal Article AU - Uebel, Kerry AU - Guise, Andy AU - Georgeu, Daniella AU - Colvin, Christopher AU - Lewin, Simon AB - BACKGROUND: The integration of HIV care into primary care services is one of the strategies proposed to increase access to treatment for people living with HIV/AIDS in high HIV burden countries. However, how best to do this is poorly understood. This study documents different factors influencing models of integration within clinics. METHODS: Using methods based on the meta-ethnographic approach, we synthesised the findings from three qualitative studies of the factors that influenced integration of HIV care into all consultations in primary care. The studies were conducted amongst staff and patients in South Africa during a randomised trial of nurse initiation of antiretroviral therapy (ART) and integration of HIV care into primary care services - the Streamlining Tasks and Roles to Expand Treatment and Care for HIV (STRETCH) trial. Themes from each study were identified and translated into each other to develop categories and sub-categories and then to inform higher level interpretations of the synthesised data. RESULTS: Clinics varied as to how HIV care was integrated. Existing administration systems, workload and support staff shortages tended to hinder integration. Nurses' wanted to be involved in providing HIV care and yet also expressed preferences for developing expertise in certain areas and for establishing good nurse patient relationships by specialising in certain services. Patients, in turn, were concerned about the stigma of separate HIV services and yet preferred to be seen by nurses with expertise in HIV care. These factors had conflicting effects on efforts to integrate HIV care. CONCLUSION: Local clinic factors and nurse and patient preferences in relation to care delivery should be taken into account in programmes to integrate HIV care into primary care services. The integration of medical records, monitoring and reporting systems would support clinic based efforts to integrate HIV care into primary care services. DA - 2013 DB - OpenUCT DO - 10.1186/1472-6963-13-171 DP - University of Cape Town J1 - BMC Health Services Research LK - https://open.uct.ac.za PB - University of Cape Town PY - 2013 T1 - Integrating HIV care into nurse-led primary health care services in South Africa: a synthesis of three linked qualitative studies TI - Integrating HIV care into nurse-led primary health care services in South Africa: a synthesis of three linked qualitative studies UR - http://hdl.handle.net/11427/15261 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/15261
dc.identifier.urihttp://dx.doi.org/10.1186/1472-6963-13-171
dc.identifier.vancouvercitationUebel K, Guise A, Georgeu D, Colvin C, Lewin S. Integrating HIV care into nurse-led primary health care services in South Africa: a synthesis of three linked qualitative studies. BMC Health Services Research. 2013; http://hdl.handle.net/11427/15261.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentDepartment of Public Health and Family Medicineen_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.holder2013 Uebel 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.otherIntegrationen_ZA
dc.subject.otherHIV careen_ZA
dc.subject.otherPrimary health careen_ZA
dc.subject.otherNurse specialisationen_ZA
dc.subject.otherStigmaen_ZA
dc.titleIntegrating HIV care into nurse-led primary health care services in South Africa: a synthesis of three linked qualitative studiesen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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