The impact of ART scale upon health workers: evidence from two South African districts

Abstract

This study explores the effects of antiretroviral treatment (ART) programmes on health-care human resources in South Africa. The study included two parts, a questionnaire-based survey of 269 health workers published earlier and a qualitative study of 21 purposively selected health practitioners involved in ART scale up. Contrary to what has been presented in literature, our survey showed that health workers in ART programmes experienced higher levels of morale, lower stress, lower sickness absenteeism and higher levels of job satisfaction. This paper uses qualitative data to provide insights into the working environment of ART workers and examines some possible explanations for our survey findings. The key factors that contribute to the different perception of working environment by ART workers identified in this study include bringing hope to patients, delaying deaths, acquiring training and the ability to better manage and monitor the disease.

Keywords:

• HIV/AIDS
• health workers
• South Africa
• ART

Acknowledgements

The study formed part of the Whole Systems Assessment and Response project within the UK Department for International Development (DFID) programme Knowledge for Action in HIV/AIDS and Sexually Transmitted Infections. However, DFID is not responsible for any views expressed.

Notes

1. Step-down clinics are ART clinics separate from main hospitals which manage ART regimens for AIDS patients once initiation on treatment has been done. These work on a referral system, where patients are referred from hospital to clinics but will refer patients back to hospitals when severe complications occur. These clinics also serve to reduce workload from hospitals as well as aiding rural-based patients that may live far way from main hospitals.