Draft 1 (6 September 2004)
Guidelines forsemi-structured interviews with health workers
(to be adapted for use with different type of health workers – medical doctors, nurses, counselors, pharmacists, community workers)
Name interviewer:......
Interview number:......
Date:......
- Background information on informant (health worker)
a) Sex / M / F
b) Age / Years
c) Profession
d) Name of centre
e) Role in ARV programme
f) Involved in programme since ….
- The ARV programmein this centre: access and functioning
a)When did this facility start providing active ARV treatment?
b)Who is involved in the ARV treatment programme? What is their role in treatment?
c)How many patients ARV users are currently enrolled in your centre? (m/f, adults / children)
d)What criteria and conditions are used to select patients?
e)Which combinations of ARVs are prescribed to patients as first-line therapies?
f)How are decisions concerning the switching of treatments taken?
g)What do the patients pay for the treatment themselves?
h)And how much – approximately - do they have to spend in additional costs, including transport and related costs for diagnostics, etc.?
i)Do you think costs are a problem for the ARV-users? Please explain.
j)Are there any other problemsthat affect whether and how PLWA use ARVs?
k)What are the levels of non-adherence to ARV regimes in your centre? How do you monitor adherence? What do you think are the main reasons for non-adherence?
l)Who adheres best and worst?
m)Does the health facility have a system to follow-up ARV users? If yes, how is this organized?
- Information and communication
a)In what ways are ARV-users informed about and prepared for ARV treatment?
b)What kind of information do they receive? Please describe it to us:
c)Who is giving this information?
d)What topics are covered in this information?(Tick when topic is mentioned)
- How ARVs work
- How to use them
- The need to continue treatment
- What to do if a pill is forgotten
- Possible interactions with other drugs
- Which side effects can occur & what to do if they occur
- (Breast) feeding requirements
- When and where to get re-supply
e)Are health workers trained to inform and counsel ARV users? What topics are covered in this training?
f)Have you ever been afraid of being infected with HIV through your work? What were you specifically afraid about? How do you feel now about the HIV-infection risks? Do you take any extra precautions when working with them?
g)Do you have any contact with familyand community members to enhance adherence to ARVs? In what ways do you do this?How does this function? Please, could you give me examples of what went well and what went wrong? How effective is this adherence support measure in your view? How could it be improved?
4. Available drugs, facilities & technical skills
a)Do you have ARV treatment guidelines at this facility?
b)Do you always prescribein accordance with the guidelines? If not, in what cases / for what reasons do you sometimes deviate from the guidelines?
c)For new users, do you check the history of ARVs used previously?
d)Are diagnostic facilities (CD4 counts, viral loads) available? Which? IF not, on what basis do you initiate treatment and monitor treatment outcomes?
e)Which ARVs are in stock in the health facility? Did any stock-out of ARVs occur in the past 3 months?
5. Perceived job satisfaction, problems and possible solutions
a)How do you feel about working in the ARV treatment programme? In what way does it affect your workload and job-satisfaction?
b)What do you see as major problemsin your ARV treatment programme?
c)What do you think could be done to improve this?
6. Is there anything else you would like to tell us or ask us?
Thank you very much for your participation in this interview ………………
Guidelines for semi-structured interview with health workers1