To what extent are nurses using recognised IMCI protocols to identify and manage children with HIV: An evaluation of IMCI trained nurses in Kwazulu Natal in the use of the HIV portion of the IMCI algorithm
Africa Journal of Nursing and Midwifery
Durban University of Technology, Dept. of Postgraduate Nursing Studies, P.O. Box 1334, Durban 4000, South Africa
In South Africa HIV infection is an increasing problem. The Department of Health (2004) estimated that by the end of 2003, 5.6 million people had acquired the HIV infection. Given the mother to child transmission of the disease, a paediatric HIV epidemic is expected. These children can be identified and managed using the HIV portion of the IMCI algorithm. This evaluation study sought to assess the accuracy of the use of the HIV portion of the algorithm by IMCI trained nurses in the public sector clinics in KwaZulu Natal province. Quantitative and qualitative procedures were utilized to conduct the survey. Eight nurses were selected through a two phase sampling strategy. The selected nurses were observed and assessed for a total of 72 consultations using a checklist. In addition, a questionnaire was developed and administered to the eight nurses in the original sample as well as 5 others who were conveniently selected. The findings indicate a poor level of accuracy with which IMCI trained nurses' use the algorithm and therefore suggest a poor level of management of HIV infection in children at clinic level in KwaZulu Natal. The findings indicated a reluctance of some IMCI trained nurses to discuss HIV infection with mothers who bring their children to the clinics. Support for IMCI nurses to accurately and effectively use the HIV portion of the IMCI algorithm needs to be introduced in order to provide a better service to children with HIV infection.