Healthcare Workers' Perceptions of Services at the Swaziland Wellness Centre

Abstract

The healthcare workforce in southern Africa is diminished by unprecedented morbidity and mortality as a result of the HIV pandemic. Healthcare workers (HCWs) have been hesitant to access care where facility staff may be unprofessional, stigmatising, or breaching client confidentiality. The Wellness Centre for Health Care Workers opened in 2006 to enhance the health and well-being of HCWs in the Kingdom of Swaziland. The Centre’s nurse-managed model of care – the first of its kind in Africa – delivers HIV and tuberculosis prevention and treatment services through a primary care, community-based clinic. Our mixed-methods study evaluated the first 10 years of the Centre’s operation; a medical record review was complemented with 23 HCW client interviews. This article reports on the qualitative component in which HCWs described their experiences of receiving services at the Centre. The Centre’s service delivery was described as acceptable by HCWs receiving care for physical and psychological conditions. Clients with HIV described a supportive and inspiring environment that lacked the stigma and mistreatment that clients had experienced in other health facilities. Nurses were well-trained, trustworthy clinicians who engaged with their clients in a compassionate manner. The Centre’s unique outreach is effective in engaging HCW clients and their family members in primary care and HIV services. The Centre’s approach may serve as a model for similar nurse-managed clinics in Africa. It is recommended that nurses caring for HCW clients be respectful, communicative, and competent clinicians. Assuring privacy and confidentiality for HCW clients may increase enrolment and retention of clients in care.