A model to ensure the integration of tuberculosis and Human Immunodeficiency Virus services in the primary health care facilities of Limpopo Province

Abstract

The aim of this study was to develop a model to ensure the integration of Tuberculosis (TB) and Human Immune Deficiency Virus (HIV) services in the Primary Health Care (PHC) facilities of Limpopo Province. An explanatory sequential mixed method was used in this study to develop a model for ensuring the integration of TB and HIV services in the PHC facilities of the Limpopo Province. The researcher collected quantitative data followed by qualitative data. Quantitative data was collected through administration of questionnaires to 450 PHC nurses in the five districts of Limpopo Province. The qualitative data was collected by conducting focus group discussions to five groups of Community Home Based Carers (CHBCs) and five groups of TB/HIV co-infected patients in the five districts of Limpopo Province. Audiotape and field notes were used to capture verbal and non-verbal cues. The Statistical Package for Social Sciences (SPSS) computer programme version 22.0 was used for capturing and analysis of the quantitative data. Content analysis was used to analyse the qualitative data from the CHBCs and the TB and HIV co-infected patients’ focus group discussions. The study revealed lack of knowledge and skills on TB and HIV management due to insufficient training of PHC nurses about TB and HIV management. Staff shortage of PHC nurses in the facilities was also indicated by PHC nurses. Furthermore, TB and HIV coinfected patients are faced with challenges in the PHC facilities and in the community. Challenges that are faced by CHBCs and the TB and HIV co-infected patients include negative attitudes of some clinic staff members towards them. The patients’ families also have some negative attitudes towards the CHBCs as they leave the patients to them without assisting them in the caring duties. The community members also has negative attitudes as they do not accept the CHBCs in their homes to support the patients. Based on the results, a model was developed to ensure the integration of TB and HIV services. The model was validated by PHC nurses and the experts in research and model development. The validation results showed that the model was clear and simple to be used in the PHC facilities for integration of TB and HIV services. The study recommends that the model should be used by PHC facilities for integration of TB and HIV services. The PHC nurses should attend TB and HIV capacity-building courses.