HIV policy implementation challenges: experiences of HIV managers in primary healthcare facilities in the Western Cape

Abstract

Background: Implementing HIV policy involves translating policy goals into practical action. In the Western Cape, South Africa, the lack of clear guidelines has challenged the consistent implementation of HIV policies at primary healthcare (PHC) facilities. Objectives: This study aimed to explore HIV managers’ experiences regarding the challenges of HIV policy implementation at PHC facilities within the Northern Tygerberg sub-district, Cape Metropole, Western Cape. Method: An exploratory, descriptive, qualitative design was employed. Purposive sampling was applied to select HIV managers (n = 10) with experience in policy implementation. Data were collected through semi-structured interviews and analysed using thematic analysis. Results: Four themes emerged from the study, reflecting the challenges experienced by HIV managers during the implementation of HIV policies at PHC facilities, including human resource challenges, staff knowledge and attitudes, system readiness, and training. Conclusion: Effective implementation of HIV policy remains essential to the national HIV response. While significant targets have been achieved, ongoing systemic challenges continue to hinder optimal policy execution and the delivery of services. Contribution: The study highlights the critical need for stronger human resource systems, improved training platforms, and enhanced facility infrastructure to ensure effective HIV policy implementation and better health outcomes for individuals living with HIV.