Implementing nurse-initiated and managed antiretroviral treatment (NIMART) in South Africa: A qualitative process evaluation of the STRETCH trial

Georgeu, Daniella, Colvin, Christopher J., Lewin, Simon, Fairall, Lara, Bachmann, Max O., Uebel, Kerry, Zwarenstein, Merrick, Draper, Beverly and Bateman, Eric D. (2012) Implementing nurse-initiated and managed antiretroviral treatment (NIMART) in South Africa: A qualitative process evaluation of the STRETCH trial. Implementation Science, 7. ISSN 1748-5908

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Abstract

Task-shifting is promoted widely as a mechanism for expanding antiretroviral treatment (ART) access. However, the evidence for nurse-initiated and managed ART (NIMART) in Africa is limited, and little is known about the key barriers and enablers to implementing NIMART programmes on a large scale. The STRETCH (Streamlining Tasks and Roles to Expand Treatment and Care for HIV) programme was a complex educational and organisational intervention implemented in the Free State Province of South Africa to enable nurses providing primary HIV/AIDS care to expand their roles and include aspects of care and treatment usually provided by physicians. STRETCH used a phased implementation approach and ART treatment guidelines tailored specifically to nurses. The effects of STRETCH on pre-ART mortality, ART provision, and the quality of HIV/ART care were evaluated through a randomised controlled trial. This study was conducted alongside the trial to develop a contextualised understanding of factors affecting the implementation of the programme.

Item Type:	Article
Uncontrolled Keywords:	qualitative research,clinical competence,randomized controlled trials as topic,workload,anti-hiv agents,attitude of health personnel,humans,primary health care,nursing staff,process assessment (health care),inservice training,hiv infections,patient acceptance of health care,health plan implementation,south africa,nurse's practice patterns,sdg 3 - good health and well-being ,/dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Science > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Health Services and Primary Care Faculty of Medicine and Health Sciences > Research Centres > Population Health
Depositing User:	Pure Connector
Date Deposited:	26 Jun 2013 10:55
Last Modified:	06 Feb 2025 04:15
URI:	https://ueaeprints.uea.ac.uk/id/eprint/42503
DOI:	10.1186/1748-5908-7-66

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