Knowledge and Perceptions of People Living With HIV Regarding The HIV Services That Are Offered By The Community Health Workers in KwaZulu-Natal, South Africa

Abstract

Background: KwaZulu-Natal (KZN) is the province with the highest HIV prevalence in South Africa (SA). Community Health Workers (CHWs) are key to delivery of HIV services at community level. Evidence on knowledge and perceptions of people living with HIV (PLWH) regarding the HIV services that are offered by the CHWs is limited. Therefore, this study seeks to determine knowledge and perceptions of PLWH regarding the HIV services that are offered by the CHWs in KZN.Methods: The study design was a quantitative survey using an administrator-administered questionnaire. A total of 303 PLWH from 3 selected KZN clinics were interviewed to determine their knowledge and perceptions of HIV services offered by the CHWs. Statistical Package for Social Sciences (SPSS) version 27 was used to describe the population and testing for associations between variables. The significant level was set at a p value ≤ 0.05 and at 95% confidence internal.Results: Among the 303 PLWH surveyed, 24 (8%), knew about the HIV services offered by the CHWs and of the 89 (29%) participants that were visited by CHWs, 73 (82%) had a positive perception about these services. Participants who were visited by a CHW were more likely (OR=1.57, 95% CI: 0.57-4.35) to know about the HIV services. Knowledge of HIV services was significantly associated with the positive perception of the HIV services (p<0.05). Knowledge and perception of the HIV services was not associated with age, gender, level of education or duration of visiting the clinic.Conclusion: The majority of PLWH in KZN have poor knowledge of HIV services offered by the CHWs and most of them have never been visited by a CHW in their homes. Those that were visited by CHWs were more likely to have positive perceptions regarding their HIV services. The findings of the study should trigger the scaling up of HIV community targeted initiatives that are delivered by CHWs in order to curb the HIV epidemic in the province.

How Were Return-of-Service Schemes Developed and Implemented in Botswana, Eswatini and Lesotho?

“…Broadly, the governments have two programmes that benefit health workers, namely, the in-service programme for government employees and the pre-service programme for future employees, mostly youth with high academic grades at school [29][30][31][32][33][34] (Table 2).…”

“…Broadly, the governments have two programmes that benefit health workers, namely, the in-service programme for government employees and the pre-service programme for future employees, mostly youth with high academic grades at school [29][30][31][32][33][34] (Table 2). The stewardship for the in-service programmes is the Ministry of Health in Botswana, the Ministry of Public Service in Eswatini and the NMDS in Lesotho [30][31][32][33][34].…”

“…Broadly, the governments have two programmes that benefit health workers, namely, the in-service programme for government employees and the pre-service programme for future employees, mostly youth with high academic grades at school [29][30][31][32][33][34] (Table 2). The stewardship for the in-service programmes is the Ministry of Health in Botswana, the Ministry of Public Service in Eswatini and the NMDS in Lesotho [30][31][32][33][34]. Whilst the NMDS is also responsible for the pre-service programme in Lesotho, the Ministry of Education and Ministry of Labour are responsible for the pre-service programme in Botswana and Eswatini, respectively [4,[17][18][19][20]32,33,[35][36][37][38].…”

“…At least one of each of the countries' policies places emphasis on the need to ensure that citizens are prioritised to take up job opportunities in all sectors, especially the public sector [18,[29][30][31][32][33][38][39][40][41]. Foreigners are only employed when there is no citizen who can perform the same job.…”

“…Anticipating independence (which eventually came in 1968), the Eswatini government launched the localisation and training policy in 1965, where nationals would be trained to take up these strategic positions upon their return [31,39,40]. Building on the localisation policy, in 1977, there was then a formal government scholarship programme which trained nationals for public and private sector positions.…”