Management of Co-Morbidity of Depression and Chronic Non-Communicable Diseases in Rwanda

BACKGROUND: Chronic non-communicable diseases (NCDs) are a major global health problem of the 21 stcentury. They are now the world's leading cause of disease burden and high mortality. An even more alarming health problem is when depression coexists with chronic NCDs, as is frequently the case. Management of this co-morbidity with collaborative care has become a global topic of interest, with the World Health Organization (WHO) recommending implementation of collaborative care for this purpose. The study investigated existing protocols and/or interventions for managing this co-morbidity in Rwandan district hospitals. METHODS: The study used an action research design involving a research team of 14 health care professionals to collaboratively identify existing protocols or interventions for managing co-morbidity of depression and NCDs in Rwanda. Focus group discussion using a structured interview guide was used to collect qualitative data, followed by qualitative content analysis using inductive approach. RESULTS: We found no particular protocols or interventions in place to manage the co-morbidity of depression and chronic NCDs. Depression and chronic NCDs were found to be treated separately, in separate health care settings and by different health professionals. CONCLUSION: The findings revealed a gap in management of co-morbid depression and chronic NCDs in Rwanda district hospitals. We recommend that health care providers follow the WHO collaborative care advisory for better quality care and better patient improvement in management of this co-morbidity.