{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T18:11:15Z","timestamp":1778868675574,"version":"3.51.4"},"reference-count":38,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000155","name":"Social Sciences and Humanities Research Council of Canada","doi-asserted-by":"publisher","award":["611-2023- 0115"],"award-info":[{"award-number":["611-2023- 0115"]}],"id":[{"id":"10.13039\/501100000155","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009130","name":"Programme Development Grants","doi-asserted-by":"publisher","award":["890-2024-0207"],"award-info":[{"award-number":["890-2024-0207"]}],"id":[{"id":"10.13039\/501100009130","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004381","name":"Western University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004381","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007112","name":"University of Cape Town","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007112","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Frontline healthcare workers providing HIV services to children, adolescents and their families in Africa face significant stressors and well-being related challenges. These in turn may also impact their ability to provide high-quality, compassionate care. Despite healthcare providers\u2019 central role in the delivery of care and support for others, there is limited research exploring their well-being and self-care. This study examined the well-being and self-care-related challenges and needs among healthcare workers providing HIV services to children, adolescents and their caregivers in Africa. A qualitative study design was employed, including participatory priority-setting and focus group discussions with 801 providers across 24 sites in 12 high HIV-prevalence African countries. Data were thematically analysed and Orem\u2019s Theory of Self-Care and the Self-Care Matrix were employed to guide the interpretation and organization of findings. The study identified four major themes. First, participants described burnout and personal struggles as well-being related challenges. Second, they described the belief that addressing these challenges was important for their own well-being, as well as the well-being of their patients. Third, awareness of healthcare worker well-being, alongside effective communication are important contributors to a healthier workforce. Lastly, several interventions were suggested, including fostering teamwork, providing education, and offering psychosocial support within the workplace. Findings emphasize the critical need for tailored interventions that can inform future practices and strategies for healthcare worker well-being. Ultimately, these interventions are crucial for better supporting healthcare providers, enhancing their well-being, and addressing the ongoing challenges in HIV care to children and adolescents in Africa.<\/jats:p>","DOI":"10.1371\/journal.pone.0335298","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T17:31:26Z","timestamp":1778866286000},"page":"e0335298","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["\u2018We need to be supported so that we are able to also provide better care\u2019 Well-being and self-care needs among health workers providing HIV care to children and adolescents in Africa: Qualitative findings from 12 high HIV-prevalence African countries"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-3453-8193","authenticated-orcid":true,"given":"Carley","family":"Citron","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lesley","family":"Gittings","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan","family":"Oberwasserlechner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnes","family":"Ronan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luann","family":"Hatane","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,5,15]]},"reference":[{"key":"pone.0335298.ref001","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1057\/s41599-022-01093-9","article-title":"Exploring the experiences, psychological well-being and Needs of frontline healthcare workers of government hospitals in India: A qualitative Study","volume":"9","author":"J Romate","year":"2022","journal-title":"Humanities and Social Sciences Communications"},{"issue":"3","key":"pone.0335298.ref002","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1080\/01488376.2020.1817228","article-title":"The professional is the personal: A qualitative exploration of self-care practices in clinical infant mental.Health practitioners","volume":"47","author":"T Eaves","year":"2020","journal-title":"Journal of Social Service Research"},{"issue":"1","key":"pone.0335298.ref003","doi-asserted-by":"crossref","first-page":"1984","DOI":"10.4081\/hpr.2015.1984","article-title":"The impact of healthcare workers job environment on their mental-emotional health coping strategies: The case of a local general hospital","volume":"3","author":"A Koinis","year":"2015","journal-title":"Health psychology research"},{"issue":"3","key":"pone.0335298.ref004","doi-asserted-by":"crossref","first-page":"175","DOI":"10.2989\/16085906.2023.2246435","article-title":"Factors influencing the transition from paediatric to adult HIV care in the Western Cape, South Africa: Perspectives of health care providers","volume":"22","author":"S Mbebe","year":"2023","journal-title":"African Journal of AIDS Research"},{"issue":"1","key":"pone.0335298.ref005","doi-asserted-by":"crossref","DOI":"10.1186\/s13104-022-06006-2","article-title":"Past and current status of adolescents living with HIV in South Africa, 2005\u20132017","volume":"15","author":"I Naidoo","year":"2022","journal-title":"BMC Research Notes"},{"key":"pone.0335298.ref006","unstructured":"Roser M, Ritchie H. HIV\/ AIDS. Our World in Data. 2023. https:\/\/ourworldindata.org\/hiv-aids"},{"issue":"12","key":"pone.0335298.ref007","doi-asserted-by":"crossref","first-page":"2047","DOI":"10.1097\/QAD.0000000000003007","article-title":"Recognizing and supporting health workers to advance and sustain HIV gains: Lessons from PEPFAR programmes during the COVID-19 response","volume":"35","author":"JR Hoover","year":"2021","journal-title":"AIDS"},{"issue":"15","key":"pone.0335298.ref008","doi-asserted-by":"crossref","first-page":"7919","DOI":"10.3390\/ijerph18157919","article-title":"Post-traumatic stress and coping strategies of South African nurses during the second wave of the COVID-19 pandemic","volume":"18","author":"MC Engelbrecht","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"pone.0335298.ref009","doi-asserted-by":"crossref","first-page":"1204662","DOI":"10.3389\/fpubh.2023.1204662","article-title":"Mental well-being of frontline health workers post-pandemic: Lessons learned and a way forward","volume":"11","author":"T Gr\u00fcnheid","year":"2020","journal-title":"Frontiers in Public Health"},{"key":"pone.0335298.ref010","article-title":"\u2018Death by 1000 cuts\u2019: Medscape national physician burnout & suicide report 2021","author":"L Kane","year":"2021","journal-title":"Medscape Internal Medicine"},{"key":"pone.0335298.ref011","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1080\/13548506.2022.2108080","article-title":"HIV and SRH healthcare delivery experiences of South African healthcare workers and adolescents and young people during COVID-19","volume":"27","author":"J Kelly","year":"2022","journal-title":"Psychol Health Med"},{"issue":"1","key":"pone.0335298.ref012","doi-asserted-by":"crossref","DOI":"10.4102\/phcfm.v13i1.2879","article-title":"Primary care nurses\u2019 preparedness for COVID-19 in the Western Cape province, South Africa","volume":"13","author":"T Crowley","year":"2021","journal-title":"Afr J Prim Health Care Fam Med"},{"key":"pone.0335298.ref013","article-title":"The self-care matrix: A unifying framework for self-care","author":"A El-Osta","year":"2019","journal-title":"Selfcare Journal"},{"issue":"2","key":"pone.0335298.ref014","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1177\/0011000010381790","article-title":"An Organizational self-care model: Practical suggestions for development and implementation","volume":"39","author":"S Maltzman","year":"2011","journal-title":"The Counseling Psychologist"},{"issue":"3","key":"pone.0335298.ref015","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1080\/09540121.2025.2595271","article-title":"Mental health and workplace wellbeing among Frontline healthcare providers who provide HIV care to children, adolescents and their families: A mixed-methods study from twelve African countries","volume":"38","author":"L Gittings","year":"2026","journal-title":"AIDS Care"},{"key":"pone.0335298.ref016","doi-asserted-by":"crossref","first-page":"2050312119871417","DOI":"10.1177\/2050312119871417","article-title":"Low provider and staff self-care in a large safety-net HIV clinic in the Southern United States: Implications for the adoption of trauma-informed care","volume":"7","author":"JM Sales","year":"2019","journal-title":"SAGE Open Med"},{"issue":"5","key":"pone.0335298.ref017","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0266008","article-title":"\u201cUnheard,\u201d \u201cuncared for\u201d and \u201cunsupported\u201d: The mental health impact of Covid -19 on healthcare workers in KwaZulu-Natal Province, South Africa","volume":"17","author":"B Dawood","year":"2022","journal-title":"PLoS One"},{"issue":"2","key":"pone.0335298.ref018","article-title":"Burnout and self-reported suboptimal patient care amongst health care workers providing HIV care in Malawi","volume":"13","author":"MH Kim","year":"2018","journal-title":"PLoS One"},{"key":"pone.0335298.ref019","unstructured":"USAID statement \u2013 PATA Linking and Learning Hub. https:\/\/patahub.org\/usaid-statement\/. 2025."},{"key":"pone.0335298.ref020","unstructured":"PATA. About us - PATA History - Paediatric and adolescent HIV treatment. PATA | Paediatric \u2013 Adolescent Treatment Africa. https:\/\/teampata.org\/about-us\/#what-we-do. 2024."},{"key":"pone.0335298.ref021","doi-asserted-by":"crossref","DOI":"10.3362\/9781780448534","author":"M Skovdal","year":"2015","journal-title":"Qualitative Research for Development"},{"key":"pone.0335298.ref022","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1080\/09540121.2024.2308023","article-title":"Empowering and supporting frontline providers in the paediatric-adolescent HIV response: results from participatory priority-setting and group discussions in twenty-four sites in twelve high HIV-burden African countries","volume":"36","author":"L Gittings","year":"2024","journal-title":"AIDS Care"},{"key":"pone.0335298.ref023","unstructured":"Dedoose Version 9.0.107, Cloud Application for Managing, Analyzing, and Presenting Qualitative and Mixed Method Research Data. www.dedoose.com. 2023."},{"issue":"2","key":"pone.0335298.ref024","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"V Braun","year":"2006","journal-title":"Qualitative Research in Psychology"},{"issue":"1","key":"pone.0335298.ref025","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1186\/s12874-019-0707-y","article-title":"Attempting rigour and replicability in thematic analysis of qualitative research data; a case study of codebook development","volume":"19","author":"K Roberts","year":"2019","journal-title":"BMC Med Res Methodol"},{"issue":"6","key":"pone.0335298.ref026","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1177\/1524839918820038","article-title":"A Self-management training intervention: Perceptions and practices of community health workers in South Africa","volume":"21","author":"W Majee","year":"2020","journal-title":"Health Promot Pract"},{"issue":"1","key":"pone.0335298.ref027","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1080\/17290376.2017.1389300","article-title":"On the periphery of HIV and AIDS: Reflections on stress as experienced by caregivers in a child residential care facility in South Africa","volume":"14","author":"K Mohangi","year":"2017","journal-title":"SAHARA J"},{"issue":"1","key":"pone.0335298.ref028","first-page":"1","article-title":"Care for the caregiver: stress relief and burnout among health workers in HIV care","volume":"2","author":"R Atukunda","year":"2013","journal-title":"Global J Med Publ Health"},{"key":"pone.0335298.ref029","doi-asserted-by":"crossref","first-page":"1220301","DOI":"10.3389\/fpubh.2023.1220301","article-title":"Workplace wellbeing among health care workers providing HIV services in primary care in Johannesburg: A mixed methods study","volume":"11","author":"N Makina-Zimalirana","year":"2023","journal-title":"Front Public Health"},{"issue":"1","key":"pone.0335298.ref030","article-title":"Self-care practices among professional nurses employed in primary health care clinics","volume":"66","author":"GJ Nkabinde-Thamae","year":"2024","journal-title":"S Afr Fam Pract (2004)"},{"key":"pone.0335298.ref031","unstructured":"World Health Organization WHO. Self-care for health and well-being. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/self-care-health-interventions. 2024."},{"issue":"2","key":"pone.0335298.ref032","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1080\/15381501.2021.1922116","article-title":"Courtesy stigma and self-care practices among rural HIV\/AIDS healthcare providers","volume":"20","author":"FM Parks","year":"2021","journal-title":"Journal of HIV\/AIDS & Social Services"},{"issue":"3","key":"pone.0335298.ref033","doi-asserted-by":"crossref","DOI":"10.5812\/jjhs-146632","article-title":"Designing and evaluating the effectiveness of an educational intervention based on the health belief model (HBM) in promoting self-care behavior among healthcare workers","volume":"16","author":"A MohammadiDogahe","year":"2024","journal-title":"Jundishapur J Health Sci"},{"issue":"2","key":"pone.0335298.ref034","doi-asserted-by":"crossref","DOI":"10.2196\/mental.9600","article-title":"Implementing internet-based self-care programs in primary care: qualitative analysis of determinants of practice for patients and providers","volume":"5","author":"E Hermes","year":"2018","journal-title":"JMIR Ment Health"},{"issue":"10","key":"pone.0335298.ref035","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1177\/2165079915596102","article-title":"Yoga for Self-care and burnout prevention among nurses","volume":"63","author":"GK Alexander","year":"2015","journal-title":"Workplace Health Saf"},{"key":"pone.0335298.ref036","year":"2020"},{"key":"pone.0335298.ref037","first-page":"11","article-title":"Mental health and psychosocial support concerns among frontline workers within the Eastern and Southern Africa COVID-19 response","volume":"41","author":"NM Diop","year":"2022","journal-title":"Pan Afr Med J"},{"key":"pone.0335298.ref038","author":"DL Hartweg","year":"1991","journal-title":"Dorothea Orem: Self-care deficit theory"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0335298","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T17:31:34Z","timestamp":1778866294000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0335298"}},"subtitle":[],"editor":[{"given":"Vincenzo","family":"De Luca","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,5,15]]},"references-count":38,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5,15]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0335298","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,15]]}}}