Supervisors’ perceptions regarding the Zambian HIV nurse practitioner program and integrating graduates into the Zambian health system: A descriptive cross-sectional survey

Abstract

Introduction: The disease burden of HIV and AIDS in Zambia is among the highest in the world. In 2009 the HIV Nurse Practitioner (HNP) program was implemented to address the disease burden of HIV and AIDS that is worsened by a critical shortage of health care workers and in Zambia. The objective of this study was to analyze the perceptions of supervisors of the first three cohorts of graduates of the HNP program regarding the HNP role, the impact of the role on the quality of care for HIV patients and their families, and perceived challenges in integrating the HNP graduates into the Zambian health system.

Methods: This paper reports findings from a cross-sectional survey of the supervisors from the first three cohorts of Zambian HNP graduates who completed the program between 2010-2012. Thematic content analysis was used to identify themes from the responses of 60 supervisors. The project received approval from the University of xxx Research Ethics Committee and from the University of xxx Institutional Review Board.

Results: The HNP graduates’ supervisors reported an understanding of the role, and a positive perception of the impact of the HNP cadre on the quality of HIV and AIDS care for patients and their families. The perceived challenges to integration of the HNP into the Zambian health system included the need to clarify job descriptions and responsibilities for the new role within the Ministry of Health, addressing issues related to the shortage of nurses to meet other health needs, ensuring appropriate referral of complex cases, and providing ongoing HNP supervision.

Discussion: The findings in this study can be used to guide the development of this program and the development of future task-shifting programs to provide comprehensive care to patients with HIV and AIDS.