Determinants of option B+ HIV treatment adherence among HIV-positive breastfeeding women in Zimbabwe.

Zimbabwe is one of the countries in sub-Saharan Africa with the highest prevalence of HIV. Despite the launch of the Option B+ treatment approach in 2013 to eliminate mother-to-child transmission, the number of pregnant women and children living with HIV is still high due to non-adherence. This prompted this study with the aim to explore the determinants of adherence to Option B+ HIV treatment among HIV-positive breastfeeding women. This descriptive phenomenological study explored the lived experiences of 12 purposively recruited HIV-positive breastfeeding women in 2020 through in-depth interviews. The collected data were analysed using Colaizzi's phenomenological data analysis framework. The study findings revealed that client-related factors such as food insecurity, travel, early infant diagnosis, and treatment-related factors such as the unavailability of drugs, the side effects of medications, and health institution-related factors are barriers to adherence among HIV-positive breastfeeding women. The findings also indicated that support from the family, health care workers, awareness of the benefits of the treatment plan, and positive role models are promoters of adherence. To improve breastfeeding women's adherence to Option B+ HIV treatment, the identified barriers to adherence should be addressed while optimising the motivators of adherence.

Le Zimbabwe est l'un des pays d'Afrique subsaharienne où la prévalence du VIH est la plus élevée. Malgré le lancement de l'approche thérapeutique Option B+ en 2013 pour éliminer la transmission mère-enfant, le nombre de femmes enceintes et d'enfants vivant avec le VIH reste élevé en raison de la non-observance. Cela a incité cette étude dans le but d'explorer les déterminants de l'observance du traitement anti-VIH Option B+ chez les femmes séropositives qui allaitent. Cette étude phénoménologique descriptive a exploré les expériences vécues de 12 femmes allaitantes séropositives recrutées à dessein en 2020 au moyen d'entretiens approfondis. Les données collectées ont été analysées à l'aide du cadre d'analyse de données phénoménologiques de Colaizzi. Les résultats de l'étude ont révélé que des facteurs liés aux clients, tels que l'insécurité alimentaire, les voyages, le diagnostic précoce du nourrisson et des facteurs liés au traitement, tels que l'indisponibilité des médicaments, les effets secondaires des médicaments et les facteurs liés aux établissements de santé, constituent des obstacles à l'observance chez les personnes infectées par le VIH. -les femmes qui allaitent positivement. Les résultats ont également indiqué que le soutien de la famille, des agents de santé, la conscience des avantages du plan de traitement et des modèles positifs sont des facteurs favorisant l'observance. Pour améliorer l'observance des femmes qui allaitent au traitement du VIH Option B+, les obstacles identifiés à l'observance doivent être surmontés tout en optimisant les facteurs de motivation de l'observance.

Exploring quality standards implementation at a South African municipality's health facilities.

BACKGROUND:  Despite government initiatives to ensure the delivery of safe and high-quality care in health establishments, most health establishments in the City of Tshwane Metropolitan Municipality, South Africa were non-compliant with the National Core Standards. This study explored the experiences of quality assurance managers regarding quality standards implementation in these establishments. OBJECTIVES:  This study aimed to explore and describe factors affecting the implementation of quality standards at public health facilities based on quality assurance managers' lived experiences in the research setting. METHOD:  This qualitative study used phenomenological design by conducting individual in-depth interviews with nine purposively selected quality assurance managers in 2021. The collected data were analysed using Colaizzi's phenomenological analysis framework. RESULTS:  The study's findings revealed that the legislative framework and the policy environment were motivators for quality standard compliance among the participants. Furthermore, human resources, materials-related issues and poor infrastructure were found to be barriers to the implementation of quality standards in health facilities. CONCLUSION:  The explored and described barriers must be addressed to improve compliance with the National Core Standards at public health facilities in the City of Tshwane Metropolitan Municipality. In addition, capacity-building for quality assurance managers should be ongoing to ensure the highest quality implementation standards and to strengthen the enforcement of quality standard regulations.Contribution: The study's findings explored and described the factors that influence the implementation of quality standards. Addressing these factors could improve the quality of healthcare delivery in the research setting's health facilities.