Exploring resource availability for nurses implementing HIV prevention guidelines in primary healthcare facilities.

Area of Science:

• Public Health
• HIV Prevention
• Healthcare Resource Management

Background:

• Pre-exposure prophylaxis (PrEP) is effective in reducing new HIV infections.
• Resource limitations in South African public health facilities hinder PrEP uptake despite established guidelines.
• Nurses face challenges implementing PrEP due to inadequate resources.

Purpose of the Study:

• To explore resource availability for nurses implementing PrEP guidelines in Johannesburg primary health settings.
• To identify barriers and facilitators to PrEP implementation related to resource availability.
• To assess the impact of structural and systemic factors on PrEP guideline implementation.

Main Methods:

• Qualitative exploratory design with an interpretive approach.
• Study conducted in four primary healthcare facilities in Johannesburg, South Africa.
• Semi-structured interviews with 19 nurses, analyzed using thematic analysis.
• Donabedian's framework used to assess structure, process, and outcomes.

Main Results:

• Three key themes emerged: structural inadequacies, insufficient healthcare system support, and unclear performance tracking.
• Resource limitations significantly impact the effective implementation of PrEP guidelines.
• Both barriers and facilitators influence PrEP implementation, emphasizing the need for healthcare system strengthening.

Conclusions:

• Critical resource limitations, including infrastructure and human resources, hinder PrEP implementation.
• Robust data management systems are essential for successful PrEP programs.
• Policy interventions are needed to strengthen infrastructure and human resources to improve PrEP uptake and retention.