Table 3 Key themes from interviews with frontline healthcare workers (HCWs) (n = 33) with supporting quotations

Theme 1: YHA is mutually beneficial to HCWs and interns

HCWs express strong affinity for YHA because they find interns to be a useful set of extra hands to support a HCW’s workload and they believe YHA benefits youth and broader society

“They are gaining experience; we are gaining extra hands. We are benefiting; they are benefiting.”

(NW-6, Nurse, CHC/Hospital)

“[The interns] are so helpful, helping hands. Whatever they do.” (NW-5, Data capturer, CHC/Hospital)

“I feel so happy because…you grow a young kid who knew nothing, and you start seeing how much impact you play for her to be here.” (NW-11, Counsellor, Clinic)

Theme 2: Facilities need agency when implementing YHA

HCWs appreciated having a say in how YHA was implemented at their facility and became frustrated if they lacked this agency. Lack of agency was connected to lack of communication with YHA

“The intern program was not properly introduced to us….The first time I saw and heard of this program–the first time–I came in the morning, I found…they were navigators there….. So now, it was causing a confusion in the sense that you don't know who are these people, they were not introduced….” (Gauteng-10, Nurse, CHC/Hospital)

“It seems as if now I am manager only [in a] vacuum because…when they take [the YHA intern] for the meeting they [do] not inform me….She doesn’t report to me, even now she is not here, I don’t know where is she.” (NW-10, Nurse, Clinic)

Theme 3: Short internships can be burdensome

The short nature of an internship can be burdensome, as HCWs spend time training interns and grow dependent on their support for them to leave after one year with no guarantee of replacement

“Honestly, the disadvantage [of YHA]? They employ people who don't have any experience. I have to come and show them the ropes, how are we doing the work here….For the first two weeks it was difficult, but my colleague, I think she is adapting very fast. So for now I don't have a problem, everything works smoothly.” (NW-16, Admin Clerk, Clinic)

“If they are leaving or [the] internships ends, there will be a gap, where I would be alone again, lots of work, with backlog.” (NW-5, Data capturer, CHC/Hospital)

Theme 4: Success from YHA is more than numbers

HCWs believed YHA led to success in numerous ways in addition to progress towards HIV targets, such as smoother facility operations, improved HCW morale, and improved patient care

“[YHA] benefits patients in a lot of ways, like for instance, our waiting time is reduced, our nursing care has improved, and our patient survey says a lot.” (Gauteng-13, Nurse, CHC/Hospital)

“You see, really if you have too much workload, you end up being exhausted and exhaustion brings burnout and end up with much absenteeism, so if we have more people working together, everything goes smoothly.” (NW-17, Nurse, Clinic)

“But now, it is easy when they are here. The work is…going smooth. The files, the doctors when they come, they find that the files are already on the chairs. They are ready because they are here since the morning. They prepare the files the day before….They put them on the boxes…..And when the patients come, they don't go far away, the files are here, nearer, they just take the file, then they take the file to the nurses, they do the vital signs, then the patients go to the doctor. It is very easy. Working is easy, smoothly.” (Gauteng-16, Nurse, CHC/Hospital)