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

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 inte...

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Autores principales: Moyo, Faith, Birungi, Josephine, Garrib, Anupam, Namakoola, Ivan, Okebe, Joseph, Kivuyo, Sokoine, Mutungi, Gerald, Mfinanga, Sayoki, Nyirenda, Moffat, Jaffar, Shabbar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Ubiquity Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10418142/
https://www.ncbi.nlm.nih.gov/pubmed/37577142
http://dx.doi.org/10.5334/ijic.6962
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author Moyo, Faith
Birungi, Josephine
Garrib, Anupam
Namakoola, Ivan
Okebe, Joseph
Kivuyo, Sokoine
Mutungi, Gerald
Mfinanga, Sayoki
Nyirenda, Moffat
Jaffar, Shabbar
author_facet Moyo, Faith
Birungi, Josephine
Garrib, Anupam
Namakoola, Ivan
Okebe, Joseph
Kivuyo, Sokoine
Mutungi, Gerald
Mfinanga, Sayoki
Nyirenda, Moffat
Jaffar, Shabbar
author_sort Moyo, Faith
collection PubMed
description 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.
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spelling pubmed-104181422023-08-12 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 Namakoola, Ivan Okebe, Joseph Kivuyo, Sokoine Mutungi, Gerald Mfinanga, Sayoki Nyirenda, Moffat Jaffar, Shabbar Int J Integr Care Integrated Care Case 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. Ubiquity Press 2023-08-11 /pmc/articles/PMC10418142/ /pubmed/37577142 http://dx.doi.org/10.5334/ijic.6962 Text en Copyright: © 2023 The Author(s) https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/.
spellingShingle Integrated Care Case
Moyo, Faith
Birungi, Josephine
Garrib, Anupam
Namakoola, Ivan
Okebe, Joseph
Kivuyo, Sokoine
Mutungi, Gerald
Mfinanga, Sayoki
Nyirenda, Moffat
Jaffar, Shabbar
Scaling up integrated care for HIV and other chronic conditions in routine health care settings in sub-Saharan Africa: Field notes from Uganda
title Scaling up integrated care for HIV and other chronic conditions in routine health care settings in sub-Saharan Africa: Field notes from Uganda
title_full Scaling up integrated care for HIV and other chronic conditions in routine health care settings in sub-Saharan Africa: Field notes from Uganda
title_fullStr Scaling up integrated care for HIV and other chronic conditions in routine health care settings in sub-Saharan Africa: Field notes from Uganda
title_full_unstemmed Scaling up integrated care for HIV and other chronic conditions in routine health care settings in sub-Saharan Africa: Field notes from Uganda
title_short Scaling up integrated care for HIV and other chronic conditions in routine health care settings in sub-Saharan Africa: Field notes from Uganda
title_sort scaling up integrated care for hiv and other chronic conditions in routine health care settings in sub-saharan africa: field notes from uganda
topic Integrated Care Case
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10418142/
https://www.ncbi.nlm.nih.gov/pubmed/37577142
http://dx.doi.org/10.5334/ijic.6962
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