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Hope is the pillar of the universe: Health-care providers' experiences of delivering anti-retroviral therapy in primary health-care clinics in the Free State province of South Africa

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  • Stein, Joanne
  • Lewin, Simon
  • Fairall, Lara

Abstract

South Africa is experiencing one of the largest HIV/AIDS epidemics in the world. A national, publicly funded anti-retroviral therapy (ART) programme has recently been launched. This paper describes the findings from a qualitative study of the views of health-care professionals, especially nurses, regarding the ART roll-out in the Free State province of South Africa, where nurses are responsible for most of the care delivered to AIDS patients. The study highlights the hope provided by the new programme and the motivation it has engendered among nurses. Apart from long waiting lists for ART, these professionals saw the main programme challenge as the integration of a holistic model of patient-centred care, inclusive of psycho-social support, into an under-resourced primary health-care system. By comparison, neither the increasing clinical responsibilities borne by nurses, nor the ability of patients to adhere to ART, were seen as key problems. This study suggests that the ART programme has mobilised health workers to assume responsibility for providing high-quality care in an under-resourced setting.

Suggested Citation

  • Stein, Joanne & Lewin, Simon & Fairall, Lara, 2007. "Hope is the pillar of the universe: Health-care providers' experiences of delivering anti-retroviral therapy in primary health-care clinics in the Free State province of South Africa," Social Science & Medicine, Elsevier, vol. 64(4), pages 954-964, February.
    • Handle: RePEc:eee:socmed:v:64:y:2007:i:4:p:954-964
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    Cited by:

    1. Rhodes, Tim & Bernays, Sarah & Terzic, Katarina Jankovic, 2009. "Medical promise and the recalibration of expectation: Hope and HIV treatment engagement in a transitional setting," Social Science & Medicine, Elsevier, vol. 68(6), pages 1050-1059, March.
    2. van Ginneken, Nadja & Lewin, Simon & Berridge, Virginia, 2010. "The emergence of community health worker programmes in the late apartheid era in South Africa: An historical analysis," Social Science & Medicine, Elsevier, vol. 71(6), pages 1110-1118, September.
    3. Nam, Sara L. & Fielding, Katherine & Avalos, Ava & Dickinson, Diana & Gaolathe, Tendani & Geissler, P. Wenzel, 2008. "The relationship of acceptance or denial of HIV-status to antiretroviral adherence among adult HIV patients in urban Botswana," Social Science & Medicine, Elsevier, vol. 67(2), pages 301-310, July.
    4. Derick W. Brinkerhoff, 2016. "Building political will for HIV response: an operational model and strategy options," International Journal of Health Planning and Management, Wiley Blackwell, vol. 31(4), pages 470-487, October.
    5. Lewin, Simon & Green, Judith, 2009. "Ritual and the organisation of care in primary care clinics in Cape Town, South Africa," Social Science & Medicine, Elsevier, vol. 68(8), pages 1464-1471, April.

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