Ahmed Charisse V, Weissinger Guy, Teitelman Anne M, Dlamini Ndumiso Sabelo, Dlamini Nontsikelelo Patience, Dlamini Thuthukile Cebsile, Nkambule Angel, Nkambule Siphesihle, Rice Bridgette M, Calnan Marianne
University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA.
University Research Co., LLC, Mbabane, Eswatini.
Afr J AIDS Res. 2023 Apr;22(1):27-34. doi: 10.2989/16085906.2023.2169178. Epub 2023 Mar 29.
We aimed to elucidate the specific roles and responsibilities of expert clients in service delivery among adolescents living with HIV in Eswatini, and to provide recommendations for enhancing adolescent service provision among expert clients and similar lay health workers throughout low- and middle-income countries. An exploratory qualitative descriptive methodology using conventional content analysis was used to meet our study aims. We recruited 20 expert clients and 12 key informants (programme managers, programme coordinators and nurses) to participate in semi-structured interviews, and we arranged four focus group discussions among adolescents living with HIV with seven to ten participants per focus group. Adherence counselling in clinical and community settings was considered paramount to the roles and responsibilities of expert clients with regard to adolescent-specific HIV service delivery. The following recommendations were made to enhance expert client service delivery practices among adolescents: (1) training in adolescent developmental, sexual and reproductive needs; (2) training to enhance clinical knowledge and skills; (3) additional work equipment and compensation; and d) more parent and guardian engagement in their work. While expert clients meet the needs of adolescents living with HIV in several capacities, they require additional resources, skills and training to improve their work, especially in the realm of sexual and reproductive health. Future research is needed to evaluate the impact of expert client service delivery on adolescent health outcomes.
我们旨在阐明斯威士兰艾滋病毒感染青少年服务提供中专家客户的具体角色和职责，并为在低收入和中等收入国家的专家客户及类似的非专业卫生工作者中加强青少年服务提供提出建议。采用常规内容分析法的探索性定性描述方法来实现我们的研究目标。我们招募了20名专家客户和12名关键信息提供者（项目经理、项目协调员和护士）参与半结构化访谈，并在艾滋病毒感染青少年中安排了4次焦点小组讨论，每个焦点小组有7至10名参与者。在临床和社区环境中提供依从性咨询被认为是专家客户在针对青少年的艾滋病毒服务提供方面的角色和职责的重中之重。为加强专家客户在青少年中的服务提供实践，提出了以下建议：（1）开展青少年发育、性和生殖需求方面的培训；（2）进行提升临床知识和技能的培训；（3）提供额外的工作设备和报酬；以及（4）让更多家长和监护人参与他们的工作。虽然专家客户在多个方面满足了艾滋病毒感染青少年的需求，但他们需要更多资源、技能和培训来改进工作，特别是在性健康和生殖健康领域。未来需要开展研究来评估专家客户服务提供对青少年健康结果的影响。
