Journal of Public Health and Diseases

Most of patients in Lesotho receive health care in primary health care (PHC) facilities which are mostly managed by nurses. PHC facilities, which comprise health center facilities, are settings at which basic health care services (including antiretroviral therapy (ART)) which are affordable and accessible are targeted towards individuals, families, communities or groups. In Lesotho, antiretroviral therapy was initiated in 2001 and the free ART program started in November 2004. As the prevalence of HIV/AIDS remains high in Lesotho (25%), not much is known about the accessibility of the ART program in these settings. The aim of this study was to evaluate the ART program accessibility in PHC settings of Lesotho. A cross-sectional survey was conducted from September to November 2015 and quota sampling was used to select nurses involved in the program. A structured self-report questionnaire was used to collect data from 197 respondents and it was analyzed using SPSS version 23. It was found that 100% of PHC facilities were managed by registered nurses, registered nurse midwives or nurse clinicians and their professional titles did not affect service provision. The nurses spent an average of 4.6 (CI=3.5-4.9) years at the PHC facilities and had an average of 9.7 (CI=8.5-11.4) years in clinical practice. The mean number of patients was 173 (CI=138-175) and they spent on average 2.7 (CI=2.4-3.0) hours seeking the services. ART and prevention of mother to child transmission (PMTCT) services were accessible and offered for 4.5 (CI=4.4-4.7) days every week, but not offered on the same days and in the exact same manner. This was due to nurses’ different preferences resulting from differing staffing patterns and workload. In order to improve the current situation, standardized ART service delivery, driven by coordinated services offered on similar days and performed by staffing patterns in line with patient numbers should be encouraged.