An integrated support model for lay health care workers to improve clients' retention in HIV care.

Abstract

Background:  Retention in care is vital for the successful management of human immunodeficiency virus (HIV). About 20% of clients interrupt their HIV therapy within 6 months of starting it. Lay healthcare workers complement the healthcare professionals to provide services across the HIV care continuum. However, there is limited support for lay healthcare workers as compared to healthcare professionals. Therefore, this study was conducted at a primary healthcare centre in South Africa to develop a support model for lay healthcare workers to improve clients' retention in HIV care.

Methods:  Interviews were conducted with the lay healthcare workers, their supervisors, nurses and clients on antiretroviral therapy. The support model was then developed by following Dickoff's survey list of a theoretical framework and the theory development processes of Chinn et al. Results: The context, agent, recipient, dynamics, procedure and outcomes of support were described in the support model. To nurture lay healthcare workers, the nurses, supervisors and department of health must provide a good environment, recognise each person's needs, offer both practical and emotional support, encourage mutual reliance and provide feedback.

Conclusion:  Support is an ongoing, mutually beneficial action that is essential to the efficient operation of lay healthcare workers. Contribution: Improved motivation, job satisfaction, competence and thriving are possible outcomes of the support for lay healthcare workers. This would increase the number of clients retained in HIV care, improve viral suppression and reduce transmission.