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ARTICLE
https://doi.org/10.25159/2520-5293/2862
ISSN 2520-5293 (Online), ISSN 1682-5055 (Print)
© Unisa Press 2017
Africa Journal of Nursing and Midwifery
https://upjournals.co.za/index.php/AJNM/index
Volume 19 | Number 3 | 2017 | #2862 | 20 pages
FACILITATORS FOR AND BARRIERS TO THE
IMPLEMENTATION OF NATIONAL TUBERCULOSIS
MANAGEMENT GUIDELINES
Lucretia V. Dlwati, DLitt et Phil Thandisizwe R. Mavundla, DCur
https://orcid.org/0000-0002-3925-0926 https://orcid.org/0000-0002-4673-9383
Walter Sisulu University, University of South Africa,
School of Nursing Sciences Department of Health Studies
Fungai Mbengo, MPH
https://orcid.org/0000-0001-9056-1896
University of South Africa,
Department of Health Studies
ABSTRACT
The South African government developed the National Tuberculosis Management
Guidelines (NTBMGs) to provide guidance to professional healthcare workers on the
management of people with TB and also those co-infected with HIV. However, little is
known about primary healthcare (PHC) nurses’ perceptions of the implementation of the
NTBMGs, despite their critical role in TB management. The purpose of this study was to
explore PHC nurses’ perception of the implementation of the NTBMGs in order to identify
factors infuencing the implementation of the NTBMGs and to make recommendations to
improve the implementation of the NTBMGs. The study was conducted in the Eastern Cape,
South Africa. The Normalization Process Model (NPM) was used as a theoretical framework
to understand the factors infuencing the implementation of the NTBMGs. A qualitative,
explorative, descriptive and contextual research design was utilised. Data were collected
using individual semi-structured interviews on a purposive sample of 10 PHC nurses working
in rural clinics. Data were analysed following a descriptive method of Tesch. The study
revealed several facilitators for and barriers to the implementation of the NTBMGs based on
the NPM. The facilitators included the PHC nurses’ satisfaction with the Directly Observed
Treatment, Short Course (DOTS) strategy in rendering health services to TB patients, and
the PHC nurses’ perception of TB meetings as an appropriate platform for problem-solving,
of the NTBMGs to be consistent with TB management, and of job satisfaction in relation to