Scaling up integrated care for HIV and other chronic conditions in routine health care settings in sub-Saharan Africa: Field notes from Uganda

Moyo, Faith, Birungi, Josephine, Garrib, Anupam ORCID: https://orcid.org/0000-0003-2305-3749, Namakoola, Ivan, Okebe, Joseph ORCID: https://orcid.org/0000-0001-5466-1611, Kivuyo, Sokoine, Mutungi, Gerald, Mfinanga, Sayoki, Nyirenda, Moffat and Jaffar, Shabbar ORCID: https://orcid.org/0000-0002-9615-1588 (2023) 'Scaling up integrated care for HIV and other chronic conditions in routine health care settings in sub-Saharan Africa: Field notes from Uganda'. International Journal of Integrated Care, Vol 23, Issue 3, e8.

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Abstract

Introduction: Integration of HIV and non-communicable disease (NCD) services is proposed to increase efficiency and coverage of NCD care in sub-Saharan Africa.

Description: Between October 2018 to January 2020 in Tanzania and Uganda, working in partnership with health services, we introduced an integrated chronic care model for people with HIV, diabetes and hypertension. In this model, patients were able to access care from a single point of care, as opposed to the standard of siloed care from vertical clinics. When the study ended, routine clinical services adopted the integrated model. In this article, we discuss how the model transitioned post hand-over in Uganda and draw lessons to inform future scale-up.

Discussion: The findings suggest potential for successful uptake of integrated chronic care by routine clinical services in sub-Saharan Africa. This approach may appeal to health care service providers and policy makers when they can quantify benefits that accrue from it, such as optimal utilization of health resources. For patients, integrated care may not appeal to all patients due to HIV-related stigma. Key considerations include good communication with patients, strong leadership, maintaining patient confidentiality and incorporating patient needs to facilitate successful uptake.

Conclusion: Evidence on the benefits of integrated care remains limited. More robust evidence will be essential to guide scale-up beyond research sites.

Item Type:	Article
Subjects:	W General Medicine. Health Professions > Health Services. Patients and Patient Advocacy > W 84 Health services. Delivery of health care WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503 Acquired immunodeficiency syndrome. HIV infections WK Endocrine System > WK 810 Diabetes mellitus WT Geriatrics. Chronic Disease > Chronic Disease > WT 500 General works
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.5334/ijic.6962
SWORD Depositor:	JISC Pubrouter
Depositing User:	JISC Pubrouter
Date Deposited:	21 Aug 2023 09:40
Last Modified:	14 Sep 2023 12:49
URI:	https://archive.lstmed.ac.uk/id/eprint/22991

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