Abstract
BackgroundGhana has a generalized HIV epidemic and efforts have been made to curb the spread and reverse its effects on the general population. In the wake of COVID-19 pandemic, the health system was unsettled and antiretroviral therapy (ART) care has been impacted in diverse ways. The study sought to explore the effects of COVID-19 on ART service provision in Ghana from the perspectives of the healthcare workers.MethodsAn exploratory-descriptive qualitative approach was employed in this study. Using maximum variation sampling method, fifteen healthcare workers; nurses, data managers and pharmacists were recruited from an ART clinic in a Teaching Hospital in Ghana. In-depth interviews were conducted and analysed using Braun and Clarke thematic approach.ResultsThree themes emerged from the data; “… And the pandemic struck”, “Impact of the pandemic on ART service delivery”; “Effecting the needed change”. The healthcare workers’ initial reactions to the pandemic and their show of commitment in ensuring continued ART service was evident. COVID-19 impacted service delivery in three main ways; (1) clients’ clinic attendance was erratic at various stages of the pandemic, (2) irregular resource availability as shortage was reported due to affected last mile delivery as a result of the lockdown in Accra, and (3) the health worker-patient interaction became less engaging because of established COVID-19 protocols. The healthcare workers however instituted strategies such as adjusting the patient appointment schedule, health professionals’ work schedule, establishing several work stations, task-shifting, and ensuring the implementation of all the COVID-19 protocols within the ART unit to ensure consistent service delivery as well as patient and staff safety. The study also found a decline in the implementation of several strategies established in the ART clinic during the initial phases of the pandemic such as a decline in the supply of Personal Protective Equipment (PPEs) by hospital management.ConclusionsAlthough several strategies were implemented to manage the effects of the pandemic on ART care, there is a need to establish pathways of support for healthcare workers within the ART clinic and to consolidate as well as institutionalise the changes that ensured continuous but safe service delivery.
Highlights
Ghana has a generalized Human Immunodefi‐ ciency Virus (HIV) epidemic and efforts have been made to curb the spread and reverse its effects on the general population
The population comprised of nurses, data managers and pharmacists who provided care in the antiret‐ roviral therapy (ART) clinic at the Cape Coast Teaching Hospital in Ghana
Most of the participants were community health nurses (n = 12/15) and the person with the highest experience of providing care in the ART clinic to persons living with HIV had worked for 15 years
Summary
Ghana has a generalized HIV epidemic and efforts have been made to curb the spread and reverse its effects on the general population. In the wake of COVID-19 pandemic, the health system was unsettled and antiret‐ roviral therapy (ART) care has been impacted in diverse ways. The study sought to explore the effects of COVID-19 on ART service provision in Ghana from the perspectives of the healthcare workers. Abraham et al BMC Health Services Research (2021) 21:1295 committed to the UNAIDS call to eliminate AIDS by 2030 with the focus on reducing new HIV infections by 80% and AIDS-related death by 80% [3]. Ghana was not exempted from the ravaging effects of the pandemic and ranks as the third most impacted country in the WHO Africa region [6]. Ghana like several countries instituted a ban on social gathering, tracing infected persons and their contacts, and lockdown in Accra and Kumasi; the biggest cities in Ghana, from where supplies are commonly picked [6]
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