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. ORCID: https://orcid.org/0000-0003-1770-3506, 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
Depositing User: Pure Connector
Date Deposited: 26 Jun 2013 10:55
Last Modified: 24 Oct 2022 04:21
URI: https://ueaeprints.uea.ac.uk/id/eprint/42503
DOI: 10.1186/1748-5908-7-66

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