scholarly journals Stakeholders’ Perspectives for the Development of a Point-of-Care Diagnostics Curriculum in Rural Primary Clinics in South Africa—Nominal Group Technique

Diagnostics ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 195 ◽  
Author(s):  
Nkosinothando Chamane ◽  
Desmond Kuupiel ◽  
Tivani Phosa Mashamba-Thompson
Keyword(s):  
South Africa ◽  
Hiv Testing ◽  
Point Of Care ◽  
Nominal Group Technique ◽  
Nominal Group ◽  
Point Of Care Diagnostics ◽  
Kwazulu Natal ◽  
Hiv Testing And Counselling ◽  
Professional Nurses ◽  
Testing Standards

Poor knowledge and adherence to point-of-care (POC) HIV testing standards have been reported in rural KwaZulu-Natal (KZN), a high HIV prevalent setting. Improving compliance to HIV testing standards is critical, particularly during the gradual phasing out of lay counsellor providers and the shifting of HIV testing and counselling duties to professional nurses. The main objective of this study was to identify priority areas for development of POC diagnostics curriculum to improve competence and adherence to POC diagnostics quality standards for primary healthcare (PHC) nurses in rural South Africa. Method: PHC clinic stakeholders were invited to participate in a co-creation workshop. Participants were purposely sampled from each of the 11 KwaZulu-Natal Districts. Through the Nominal Group Technique (NGT), participants identified training related challenges concerning delivery of quality point of care diagnostics and ranked them from highest to lowest priority. An importance ranking score (scale 1–5) was calculated for each of the identified challenges. Results: Study participants included three PHC professional nurses, one TB professional nurse, one HIV lay councilor, one TB assistant and three POC diagnostics researchers, aged 23–50. Participants identified ten POC diagnostics related challenges. Amongst the highest ranked challenges were the following:absence of POC testing Curriculum for nurses, absence of training of staff on HIV testing and counselling as lay counsellor providers are gradually being phased out,. absence of Continuous Professional Development opportunities and lack of Staff involvement in POC Management programs. Conclusion: Key stakeholders perceived training of PHC nurses as the highest priority for the delivery of quality POC diagnostic testing at PHC level. We recommend continual collaboration among all POC diagnostics stakeholders in the development of an accessible curriculum to improve providers’ competence and ensure sustainable quality delivery of POC diagnostic services in rural PHC clinics.

scholarly journals Multistakeholder Experiences of Providing, Receiving, and Setting Priorities for Lung Cancer Care in KwaZulu-Natal Province, South Africa

2020 ◽  
Vol 6 (Supplement_1) ◽  
pp. 25-25
Author(s):  
Khumbulani Hlongwana ◽  
Buhle Lubuzo ◽  
Phindile Mlaba ◽  
Sinenhlanhla Zondo ◽  
Themba Ginindza
Keyword(s):  
Lung Cancer ◽  
South Africa ◽  
Health Care ◽  
Family Caregivers ◽  
Health Care Professionals ◽  
Cancer Care ◽  
Nominal Group Technique ◽  
Nominal Group ◽  
Limited Access ◽  
Kwazulu Natal

PURPOSE The purpose of the study was to explore the key stakeholders’—health care professionals, patients, and family caregivers—experiences of providing, receiving, and setting priorities for lung cancer care in KwaZulu-Natal, South Africa, with a view to propose potentially effective interventions for improved care. METHODS This was a qualitative study conducted in 5 communities and 3 hospitals offering oncology services in KwaZulu-Natal Province. Data were generated using in-depth interviews and the nominal group technique. Nineteen patients with lung cancer, 20 family caregivers (FCs) and 18 health care professionals (HCPs) were interviewed, with an additional subsample of 7 HCPs participating in the nominal group technique. Results were analyzed using thematic analysis. RESULTS Similar to patients with lung cancer and FCs, HCPs were concerned about the limited access to oncology services and poor lung cancer diagnostic facilities, as these also ranked high in HCPs’ priority settings. Limited access was attributed to a lack of lung cancer awareness and low lung cancer suspicion index among different stakeholders, a shortage of health care specialists, poor diagnostic equipment and general resource constraints, unavailability of diagnostic services at the lowest levels of health care (for example, primary health care), geographic location of specialized services, and poor multidisciplinary collaboration. Patients’ perceptions of the quality of care in public health facilities also affected their treatment-seeking behavior. Challenges experienced at the health care worker-patient level also affected the FCs. For example, FCs were psychosocially and economically affected by the caring responsibilities, which, in turn, was an important determinant of a patient’s care pathways. CONCLUSION As a result of this study, new approaches to lung cancer care are being explored, including increased community awareness, the introduction of well-equipped community mobile screening services, patient navigation to track patients, and building cadres for providing and integrating palliative care services into the mainstream health systems.

scholarly journals Implementation of Point-of-Care Diagnostics in Rural Primary Healthcare Clinics in South Africa: Perspectives of Key Stakeholders

Diagnostics ◽  
2017 ◽  
Vol 7 (1) ◽  
pp. 3 ◽  
Author(s):  
Tivani Mashamba-Thompson ◽  
Ngcwalisa Jama ◽  
Benn Sartorius ◽  
Paul Drain ◽  
Rowan Thompson
Keyword(s):  
South Africa ◽  
Primary Healthcare ◽  
Point Of Care ◽  
Point Of Care Diagnostics ◽  
Key Stakeholders ◽  
Primary Healthcare Clinics

scholarly journals PIMATM point-of-care testing for CD4 counts in predicting antiretroviral initiation in HIV-infected individuals in KwaZulu-Natal, Durban, South Africa

2016 ◽  
Vol 17 (1) ◽  
Author(s):  
Mandisa Skhosana ◽  
Shabashini Reddy ◽  
Tarylee Reddy ◽  
Siphelele Ntoyanto ◽  
Elizabeth Spooner ◽  
...  
Keyword(s):  
South Africa ◽  
T Cells ◽  
T Cell ◽  
Antiretroviral Therapy ◽  
Cell Count ◽  
Point Of Care ◽  
Cd4 T Cell ◽  
Cell Counts ◽  
Kwazulu Natal ◽  
Cd4 T Cell Count

Introduction: Limited information is available on the usefulness of the PIMATM analyser in predicting antiretroviral treatment eligibility and outcome in a primary healthcare clinic setting in disadvantaged communities in KwaZulu-Natal, South Africa.Materials and methods: The study was conducted under the eThekwini Health Unit, Durban, KwaZulu-Natal. Comparison of the enumeration of CD4+ T-cells in 268 patients using the PIMATM analyser and the predicate National Health Laboratory Services (NHLS) was undertaken during January to July 2013. Bland-Altman analysis to calculate bias and limits of agreement, precision and levels of clinical misclassification at various CD4+ T-cell count thresholds was performed.Results: There was high precision of the PIMATM control bead cartridges with low and normal CD4+ T-cell counts using three different PIMATM analysers (%CV < 5). Under World Health Organization (WHO) guidelines (≤ 500 cells/mm3), the sensitivity of the PIMATM analyser was 94%, specificity 78% and positive predictive value (PPV) 95%. There were 24 (9%) misclassifications, of which 13 were false-negative in whom the mean bias was 149 CD4+ T-cells/mm3. Most (87%) patients returned for their CD4 test result but only 67% (110/164) of those eligible (≤ 350 cells/mm3) were initiated on antiretroviral therapy (ART) with a time to treatment of 49 days (interquartile range [IQR], 42–64 days).Conclusion: There was adequate agreement between PIMATM analyser and predicate NHLS CD4+ T-cell count enumeration (≤ 500 cells/mm3) in adult HIV-positive individuals. The high PPV, sensitivity and acceptable specificity of the PIMATM analyser technology lend it as a reliable tool in predicting eligibility and rapid linkage to care in ART programmes.Keywords: HIV; Point of Care; PIMATM CD4+ T cell counts; antiretroviral therapy; prediction/eligibility; South Africa

scholarly journals “I did not see a need to get tested before, everything was going well with my health”: a qualitative study of HIV-testing decision-making in KwaZulu-Natal, South Africa

AIDS Care ◽  
2017 ◽  
Vol 30 (1) ◽  
pp. 32-39 ◽  
Author(s):  
Shema Tariq ◽  
Susie Hoffman ◽  
Gita Ramjee ◽  
Joanne E. Mantell ◽  
Jessica L. Phillip ◽  
...  
Keyword(s):  
South Africa ◽  
Decision Making ◽  
Qualitative Study ◽  
Hiv Testing ◽  
Kwazulu Natal

scholarly journals Co-creation of HIVST Delivery Approaches for Improving Urban Men’s Engagement with HIV Services in eThekwini District, KwaZulu-Natal: Nominal Group Technique

2021 ◽  
Author(s):  
Tivani Phosa Mashamba-Thompson ◽  
Richard Lessells ◽  
Tafadzwa Dzinamarira ◽  
Paul Drain ◽  
Lehana Thabane
Keyword(s):  
Health Care ◽  
Hiv Testing ◽  
Nominal Group Technique ◽  
Nominal Group ◽  
Delivery Strategy ◽  
Hiv Services ◽  
Urban Men ◽  
Key Stakeholders ◽  
Self Testing ◽  
Hiv Testing Services

Background: HIV self-testing (HIVST) is one of the recommended approaches for HIV testing services, particularly for helping reach populations who would not normally access facility-based HIV testing. HIVST must be tailored to different populations to ensure uptake. Objective: The main objective of this study was to develop an acceptable HIVST delivery strategy to help improve urban men&rsquo;s engagement with HIV services. Methods: We invited key stakeholders for urban men&rsquo;s HIV services to participate in a co-creation workshop aimed at developing HIVST delivery approaches for urban men, using eThekwini municipality as a study setting. We conducted purposive sampling to include health care users and health care providers, representing a range of views across the public sector and voluntary sector. We employed the Nominal Group Technique (NGT) method for data collection. The NGT workshop was conducted in two consecutive phases: phase one was focused on determining barriers for men&rsquo;s engagement with the current/facility-based HIV testing services; phase two was aimed at determining HIVST delivery strategies. We used the results of the NGT to design a tailored HIVST strategy for urban men in eThekwini District. Results: Participants identified the following psychological factors as the most important barriers to uptake of HIV testing services by urban men: stigma, ignorance about the importance of testing and testing process as well as fear of positive test results. Key stakeholders suggested internal motivation strategies as a potentially effective approach to support HIVST delivery strategy. Guided by the NGT results, we designed a HIVST delivery strategy that is supported by a risk communication approach Conclusion: We designed an evidence-based risk communication mobile health (mHealth) strategy coupled with SARS COV-2 self-testing tailored to improve men&rsquo;s uptake of HIVST. A follow-up study to evaluate the feasibility of implementing these approaches is recommended.

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