I don’t know what I am doing because I am doing everything: perceptions and experiences of nurses about HIV counselling and testing among children in Free State Province, South Africa

Abstract

Although HIV/AIDS constitute a significant health burden among children in South Africa, testing and counselling of exposed children are inadequate. It is therefore imperative that factors relating to paediatric HCT services offered by health workers are examined. This study was conducted to explore and describe the perceptions and experiences of trained professional nurses regarding HIV counselling and testing among children. We conducted six focus group discussions among trained professional nurses in health facilities in a district in Free State Province, South Africa. All verbatim transcripts were analysed with a thematic approach and emergent codes were applied. Forty-seven trained professional nurses participated in the study and two of them were males. The age of the participants ranges from 38 to 60 years while the median age was 50 years. Most participants in the focus groups explained how HCT occurs during regular health talks and that lay counsellors are doing most of the counselling. While a few participants thought that children should not be bothered with HCT, most of them seek consent from caregivers for HIV test for children. While children whose parents are negative are usually not tested, most children are tested only when they become ill. Identified barriers to HCT among children include refusal of consent, work overload, lack of encouragement, and poor record keeping. Participants recommended improvement of issues relating to community mobilization and increasing trained staff strength for optimal paediatric HCT service delivery. Developing guidance and policies with respect to obtaining consent, recruiting more health providers, and addressing structural issues in the society to reduce stigma and discrimination were identified as key priority issues by majority of the participants. The perspectives of these participants who provide paediatric HCT services offer vital insight which may be useful to inform policy interventions.

Challenges of antiretroviral therapy among children in Free State Province, South Africa

“…The present study was part of a study whose findings have been described elsewhere. 9 The present study was conducted out in the three subdistricts of Manguang metropolitan district (Thaba Nchu, Botshabelo and Bloemfontein) of Free State Province. The prevalence of HIV infection among children aged 0-4 and 5-14 years in this province were 1.7 % and 2.7 %, respectively.…”

Leveraging routine data in impact evaluation: Understanding data systems in primary healthcare prior to a matched cluster-randomised evaluation of adherence guidelines in South Africa

“…At the same time, too many registers and duplication of record keeping can overcomplicate data collection systems, frustrate staff responsible for completing those registers and reduce providers' capacity to deliver care for patients. [6][7][8][9] In addition, high-quality routine data allow for continuity of care, assessment of treatment compliance and targeting of appropriate interventions when treatment results are suboptimal. Ideally, record-keeping systems would be simple to use, require little time to complete and be kept as up to date as possible.…”

Children and HIV – a hop (hopefully), a skip (lamentably) and a jump (ideally)?

“…These studies show the importance of quality provision, yet Coetzee, Kagee, and Bland ( 2016a ), utilizing video-recording of adherence counselling, pick up the inadequacies of these encounters which last for less than 8 min, contain very little – if any – counselling and rely on lay workers who may not provide adequately for effective adherence in children under five who are reliant upon “mediated adherence” as their caregivers administer treatment. HIV counselling and testing is believed to be inadequate for HIV-exposed children; Olaleye et al ( 2016 ) explore the perspective of the health workers who provide paediatric HIV counselling and testing. Thurman, Luckett, Taylor, and Carnay ( 2016 ) report on the impact that home visits by community-based care workers have on the likelihood of a high-risk orphaned child being tested for HIV.…”