TY - JOUR
T1 - Managing ancillary care in resource-constrained settings
T2 - Dilemmas faced by frontline HIV prevention researchers in a rural area in South Africa
AU - Nkosi, Busisiwe
AU - Seeley, Janet
AU - Chimbindi, Natsayi
AU - Zuma, Thembelihle
AU - Kelley, Maureen
AU - Shahmanesh, Maryam
PY - 2020/11/1
Y1 - 2020/11/1
N2 - Background: We describe the findings from a research ethics case study, linked with a team evaluating a package of intervention services to prevent HIV infection in adolescent girls and young women (AGYW) living in a rural and poor setting of KwaZulu-Natal, South Africa. Methods: We conducted qualitative interviews (n=77) with members of the linked research team evaluating the intervention programme, programme implementing staff, AGYW enrolled in the intervention programme, caregivers, ethics committee members, Public Engagement officers, community advisory board members and community stakeholders. Data were analysed iteratively using thematic framework analysis. Themes were determined by the study aims combined with an inductive development of codes emerging from the data. Results: The findings show that the burden of providing ancillary care fell primarily on the shoulders of frontline researchers and programme staff. Dilemmas around responding to gender-based violence illustrated the limits of ‘referral to services’ as a solution for meeting ancillary care obligations in contexts with barriers to basic health and social services. Conclusion: Our findings show important gaps in meeting ancillary care needs. Participants’ needs required social and economic support which frontline researchers and implementing partners were not able to meet, causing moral distress.
AB - Background: We describe the findings from a research ethics case study, linked with a team evaluating a package of intervention services to prevent HIV infection in adolescent girls and young women (AGYW) living in a rural and poor setting of KwaZulu-Natal, South Africa. Methods: We conducted qualitative interviews (n=77) with members of the linked research team evaluating the intervention programme, programme implementing staff, AGYW enrolled in the intervention programme, caregivers, ethics committee members, Public Engagement officers, community advisory board members and community stakeholders. Data were analysed iteratively using thematic framework analysis. Themes were determined by the study aims combined with an inductive development of codes emerging from the data. Results: The findings show that the burden of providing ancillary care fell primarily on the shoulders of frontline researchers and programme staff. Dilemmas around responding to gender-based violence illustrated the limits of ‘referral to services’ as a solution for meeting ancillary care obligations in contexts with barriers to basic health and social services. Conclusion: Our findings show important gaps in meeting ancillary care needs. Participants’ needs required social and economic support which frontline researchers and implementing partners were not able to meet, causing moral distress.
KW - Ancillary care
KW - Referral process
KW - South Africa
KW - Vulnerability
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U2 - 10.1093/inthealth/ihaa045
DO - 10.1093/inthealth/ihaa045
M3 - Article
C2 - 33165553
AN - SCOPUS:85095965581
VL - 12
SP - 543
EP - 550
JO - International health
JF - International health
SN - 1876-3413
IS - 6
ER -