Perspective Chapter: Enhancing the Nurse-Initiated Management of Antiretroviral Therapy Training and Implementation - A Conceptual Framework

Task shifting of nurse-initiated management of antiretroviral therapy (NIMART) rather than doctors is crucial to meet the increasing demand for antiretroviral therapy (ART) in primary health care in low and middle-income countries with limited healthcare resources. This chapter will furnish cooperation between the NIMART conceptual framework, National Department of Health policies and guidelines, and empirical findings regarding the management of ART and tuberculosis (TB) in South Africa and globally through pre-service and in-service training and continuous professional development (CPD). It will also include regulations and WHO guidelines on task shifting, application in a healthcare setting, the HIV continuum of care use in identifying gaps, and the development of appropriate interventions to improve patients and population health outcomes. The training and health care systems or structural challenges or barriers and strategies or enablers to enhance effective training and implementation, including the role and responsibilities of NIMART nurses, will be explored and discussed in detail. The focus will mostly be on the primary health care (PHC) setting as the first level of care and entry into the healthcare system to decentralize healthcare services and facilitate access to HIV services by the community

Adolescent Girls’ Experiences Regarding Teenage Pregnancy in the Rural Villages of Limpopo Province, South Africa

Every year, 7.3 million girls become pregnant before they turn 18. Teenage pregnancy increases when girls are denied the right to make decisions about their sexual health and well-being, which is a gender equality issue. Among the challenges of gender equality are those expectations that communities have about girls and early motherhood, sexual violence, and rape. Another challenge is the early marriages of children to older men coupled with the unique risks faced by these girls during pregnancy, for example, the interruption of their education, health risks, such as HIV, premature birth, and increased maternal mortality, denying the girls the right to live a healthy life. This study sought to explore the experiences of adolescent girls regarding teenage pregnancy in the rural villages of the Mopani District, Limpopo. A descriptive, explorative, and qualitative design was followed to collect data from 20 pregnant teenagers in a 13–19 years-old age group. A nonprobability purposive sampling method was used to select the participants from the three villages of the Mopani District. The data were collected using an in-depth individual interview. Tesch’s eight steps of data analysis were also applied. The study findings reveal several factors that explain the high rates of teenage pregnancy in rural Limpopo. Among these are the socioeconomic and cultural factors that predispose teens to pregnancy. The consequences of teenage pregnancy were expressed in terms of regret and ill health