Evaluation of the Antiretroviral Therapy Program in the Primary Health Care Settings in Lesotho

Purpose:      

The purpose of this study was to evaluate the antiretroviral therapy program in the Primary Health Care setting in Lesotho.

Objectives:   

There were five objectives for this quantitative aspect of the study.

1. Describe ART services offered in PHC settings of Lesotho

2. Determine successes and challenges in the implementation of the ART program in PHC settings of Lesotho

3. Determine if staffing patterns have an effect on number of ART services offered; number of days ART services are offered; time spent by patients seeking ART services at the facility; time taken by a patient to consult a registered nurse midwife/clinicians; Job satisfaction; Efficiency; adequacy and accessibility of ART services

4. Determine if challenges faced have an effect on number of ART services offered; number of days ART services are offered; time spent by patients seeking ART services at the facility; time taken by a patient to consult a registered nurse midwife/clinician; Job satisfaction; Efficiency; adequacy and accessibility of ART services 

5. Describe perceptions of registered nurses/ midwives/ nurse clinicians on ART program

There were two objectives for the qualitative aspect of the study.

1. Explore and describe experiences and views of registered nurse midwives/clinicians on the ART program in the PHC Settings

2. Explore and describe experiences and views of patients on the ART program in the PHC Settings

   The final objective was to develop an evaluation tool that can be used to assess the ART program in PHC settings of Lesotho

   Research Design:    A convergent parallel mixed methods design was used to collect the data. Both quantitative and qualitative data was collected and will be analysed during the same phase of the research process. Quantitative data assisted the researcher to describe the antiretroviral therapy program currently being implemented whereas the qualitative data was used to describe the experiences of both health care providers and patients on the program. The researcher believes both sets of data combined enhanced greater understanding of the ART program in the primary health care setting of Lesotho and its evaluation thereof.  The mixed methods design allowed the researcher to address a range confirmatory and exploratory questions and for stronger inferences. Use of both quantitative and qualitative data sets allowed a combination of inductive and deductive reasoning and enhanced greater confidence in the results obtained

   Research Participants:       Two groups of respondents participated in the study. The first group was composed of registered nurses/midwives/ nurse clinicians who provide amongst other services, HIV/AIDS services and were willing and available to participate in the study. The second group was composed of adults aged 18 years and older who were HIV/AIDS positive, could speak either Sesotho and/or English and were available at the time of the study.

   Significance of the study:   This study will generate new information on the ART program, its successes and challenges in Lesotho. The study will benefit;

1. Policy makers to improve the processes involved in the antiretroviral program; Implementing partners currently assisting in the propagation of the ART program to be able to understand the actual impact their assistance has during the provision of services;

2. Patients to be able to receive faster and more effective services;

3. Health care workers, especially registered nurses/ midwives/ nurse clinicians, to be able to plan execution of the antiretroviral therapy program in their health clinics effectively.

4. The researcher believes the evaluation tool used to assess the ART program can be used to inform planning at each health clinic in each district and eventually the nation as a whole. This study is therefore exploratory to potential subsequent studies that focus on implementation strategies such as the use of electronic patient record and accessibility of services regardless of place of origin that could result in a more effective and efficient program.