Facilitators and barriers to professional nurses implementing integrated services in urban primary health care clinics in Kavango East region, Namibia

Abstract

Background: The World Health Organization (WHO) has advocated for the implementation of people-centred and integrated health services. Although there is growing evidence of integration’s benefits for sexual and reproductive health, human immunodeficiency virus (HIV) and rights, health services face tremendous resource constraints when it comes to integrating these services.

Aim: The aim of study was to explore and describe the facilitators and barriers to professional nurses implementing the person-centred model of integrated services in urban primary health care clinics in the Kavango East region, Namibia.

Setting: We interviewed professional nurses from urban primary health care clinics in low-resourced settings in Rundu health district, Kavango East region, Namibia.

Methods: This study employed a qualitative approach utilising an explorative, descriptive and contextual strategy. Semistructured interviews were used to collect the data. Fifteen participants were selected using a purposive sampling technique. The interviews were audio recorded, transcribed verbatim and coded, before the data were analysed using thematic analysis.

Results: The data analysis led to the emergence of the following four themes: understanding integrated services; facilitators for implementing integrated services; barriers to the implementation of integrated services; and improvement measures for implementing integrated services.

Conclusion: Findings showed that the implementation of integrated services faces many barriers, which are related to lack of human resources skills, a lack of essential supplies and space constraints. These findings will hopefully create an awareness and understanding of the facilitators and barriers that professional nurses face in the implementation of integrated services for urban primary health care in the Namibian urban context.

Contribution: The study’s findings can be used to develop strategies and ongoing interventions that focus on addressing the barriers professional nurses face in the implementation of integrated services in both urban and rural primary health care settings.