THE CHALLENGES OF SERVICE DELIVERY, HEALTH WORKFORCE, AND INFRASTRUCTURE FOR THE DELIVERY OF ANTIRETROVIRAL THERAPY FOR HIV/ AIDS INFECTED - PERSONS IN SOUTHEAST NIGERIA
BARTHOLOMEW S. EZE *
Department of Health Administration and Management, College of Medicine, University of Nigeria, Enugu-Campus, Nigeria
OGBONNIA G. OCHONMA
Department of Health Administration and Management, College of Medicine, University of Nigeria, Enugu-Campus, Nigeria
AJUBA MIRIAM
Department of Community Medicine, Enugu State University Teaching Hospital, Enugu, Nigeria
OBINNA ONWUJEKWE
Department of Health Administration and Management, College of Medicine, University of Nigeria, Enugu-Campus, Nigeria
*Author to whom correspondence should be addressed.
Abstract
The purpose of this study was to assess the challenges posed by service delivery, health workforce and infrastructure for the delivery of antiretroviral drugs for HIV- infected persons in southeast Nigeria. Four focus group discussions (FGDs) were conducted in four randomly selected health facilities with HIV-infected adults who were receiving ART. In-depth interviews were also carried out with support group coordinators of People Living with HIV (PLWH), nurses, and ART unit heads at the health facilities. Data were transcribed verbatim and analyzed using NVivo version 8. Service delivery was poor with a loss of confidentiality, which often resulted from paper folders containing HIV-infected persons' medical notes clearly identifying them as HIV-infected. The attitudes of some health workers were also hostile to the clients. Doctors and nurses working at the centres were in short supply. There were inadequate infrastructures, which gave rise to overcrowding at the treatment centres. It is important that healthcare systems do not constitute obstacles to the life-saving intervention for HIV-infected persons.
Keywords: Access, challenges, healthcare system, HIV-infected persons, ART, Nigeria