Abstract

BackgroundThe human immunodeficiency virus and/or acquired immune deficiency syndrome (HIV/AIDS) pandemic continues to increase in prevalence worldwide, particularly in South Africa, and includes the often overlooked paediatric population. The provision of paediatric antiretroviral treatment (ART) is as essential for children as for adults, and has numerous obstacles, not least of which is lack of decentralisation of facilities to provide essential treatment. Optimising ART, care and support for HIV-positive children, and their caregivers, at public sector primary health care (PHC) clinics is crucial to improve morbidity and mortality rates in children.AimTo explore the experiences of health care professionals regarding the provision of ART for children at PHC clinics.SettingThe study was conducted in six PHC clinics in Nelson Mandela Bay Health District, Eastern Cape, South Africa.MethodologyThe researchers used a qualitative, explorative, descriptive and contextual research design with in-depth interviews. We used non-probability purposive sampling. Data collected were thematically analysed using Creswell’s data analysis spiral. We used Lincoln and Guba’s model to ensure trustworthiness. Ethical standards were applied.ResultsHealth care professionals experienced numerous challenges, such as lack of resources, need for training, mentoring and debriefing, all related to providing decentralised ART for HIV-positive children at the PHC level.ConclusionCapacitation of the health care system, integration of services, competent management and visionary leadership to invoke a collaborative interdisciplinary team approach is required to ensure that HIV is treated as a chronic disease at the PHC clinic level.

Highlights

  • An estimated 35 million people were living with human immunodeficiency virus (HIV) in 2013; 3.2 million of the 35 million are children under the age of 15 years, over 90% of whom live in sub-Saharan Africa

  • This study aimed to provide an understanding of challenges for health care professionals (HCPs) in providing ART for children attending primary health care (PHC) clinics

  • Main theme: Health care professionals experienced significant challenges related to providing antiretroviral treatment for HIVpositive children at primary health care clinics

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Summary

Introduction

An estimated 35 million people were living with human immunodeficiency virus (HIV) in 2013; 3.2 million of the 35 million are children under the age of 15 years, over 90% of whom live in sub-Saharan Africa. Improved care and treatment options have increased the lifespan of people living with HIV, provided they can access such treatment.[3] In all low- and middleincome countries, only 23% of children (aged 0–14 years) living with HIV in 2013 received ART, compared to 37% of adults living with HIV. The provision of paediatric antiretroviral treatment (ART) is as essential for children as for adults, and has numerous obstacles, not least of which is lack of decentralisation of facilities to provide essential treatment. Optimising ART, care and support for HIV-positive children, and their caregivers, at public sector primary health care (PHC) clinics is crucial to improve morbidity and mortality rates in children

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