Evaluation of a Nurse-managed Wellness Centre for Healthcare Workers in Swaziland

Abstract

Southern Africa is experiencing unprecedented levels of morbidity and mortality as a result of the HIV pandemic. Healthcare workers (HCWs) living with HIV infection may be at risk from illness and death, but may not access needed services within their workplace facility. The Swaziland Wellness Centre for Health Care Workersâ was designed to enhance the health and well-being of HCWs through a nurse-managed, community-based clinic. The purpose of the parent mixed-methods study was to describe the enrolment of clients into care over the first 10 years of the clinic’s operation and assess the HCWs’ perceptions of the Centre and its services. This report describes the findings from a retrospective review of medical records used to describe the characteristics of the clients, enrolment patterns, and services delivered. The Centre enrolled HCWs (n = 2,562) and their dependents (n = 2,571) into primary care. The HCW clients represented a variety of cadres across the health sector; nurses (29%) were the largest single cadre enrolled. The Centre nurses initiate antiretroviral and/or antitubercular treatments and provide ongoing monitoring. The database was not designed for evaluation purposes and written documentation of client care was often incomplete or illegible. The enrolment and treatment patterns suggest that nurse-managed clinics can successfully integrate HIV and tuberculosis care with primary care services for HCWs in southern Africa. Recommendations include improving the written documentation and electronic management of services provided to support ongoing evaluations.