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Integration of non-communicable disease and HIV/AIDS management: a review of healthcare policies and plans in East Africa

BACKGROUND: Low-income and middle-income countries are struggling to manage growing numbers of patients with chronic non-communicable diseases (NCDs), while services for patients with HIV infection are well established. There have been calls for integration of HIV and NCD services to increase effici...

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Autores principales: Adeyemi, Olukemi, Lyons, Mary, Njim, Tsi, Okebe, Joseph, Birungi, Josephine, Nana, Kevin, Claude Mbanya, Jean, Mfinanga, Sayoki, Ramaiya, Kaushik, Jaffar, Shabbar, Garrib, Anupam
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8098934/
https://www.ncbi.nlm.nih.gov/pubmed/33947706
http://dx.doi.org/10.1136/bmjgh-2020-004669
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author Adeyemi, Olukemi
Lyons, Mary
Njim, Tsi
Okebe, Joseph
Birungi, Josephine
Nana, Kevin
Claude Mbanya, Jean
Mfinanga, Sayoki
Ramaiya, Kaushik
Jaffar, Shabbar
Garrib, Anupam
author_facet Adeyemi, Olukemi
Lyons, Mary
Njim, Tsi
Okebe, Joseph
Birungi, Josephine
Nana, Kevin
Claude Mbanya, Jean
Mfinanga, Sayoki
Ramaiya, Kaushik
Jaffar, Shabbar
Garrib, Anupam
author_sort Adeyemi, Olukemi
collection PubMed
description BACKGROUND: Low-income and middle-income countries are struggling to manage growing numbers of patients with chronic non-communicable diseases (NCDs), while services for patients with HIV infection are well established. There have been calls for integration of HIV and NCD services to increase efficiency and improve coverage of NCD care, although evidence of effectiveness remains unclear. In this review, we assess the extent to which National HIV and NCD policies in East Africa reflect the calls for HIV-NCD service integration. METHODS: Between April 2018 and December 2020, we searched for policies, strategies and guidelines associated with HIV and NCDs programmes in Burundi, Kenya, Rwanda, South Sudan, Tanzania and Uganda. Documents were searched manually for plans for integration of HIV and NCD services. Data were analysed qualitatively using document analysis. RESULTS: Thirty-one documents were screened, and 13 contained action plans for HIV and NCDs service integration. Integrated delivery of HIV and NCD care is recommended in high level health policies and treatment guidelines in four countries in the East African region; Kenya, Rwanda, Tanzania and Uganda, mostly relating to integrating NCD care into HIV programmes. The increasing burden of NCDs, as well as a move towards person-centred differentiated delivery of services for people living with HIV, is a factor in the recent adoption of integrated HIV and NCD service delivery plans. Both South Sudan and Burundi report a focus on building their healthcare infrastructure and improving coverage and quality of healthcare provision, with no reported plans for HIV and NCD care integration. CONCLUSION: Despite the limited evidence of effectiveness, some East African countries have already taken steps towards HIV and NCD service integration. Close monitoring and evaluation of the integrated HIV and NCD programmes is necessary to provide insight into the associated benefits and risks, and to inform future service developments.
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spelling pubmed-80989342021-05-18 Integration of non-communicable disease and HIV/AIDS management: a review of healthcare policies and plans in East Africa Adeyemi, Olukemi Lyons, Mary Njim, Tsi Okebe, Joseph Birungi, Josephine Nana, Kevin Claude Mbanya, Jean Mfinanga, Sayoki Ramaiya, Kaushik Jaffar, Shabbar Garrib, Anupam BMJ Glob Health Original Research BACKGROUND: Low-income and middle-income countries are struggling to manage growing numbers of patients with chronic non-communicable diseases (NCDs), while services for patients with HIV infection are well established. There have been calls for integration of HIV and NCD services to increase efficiency and improve coverage of NCD care, although evidence of effectiveness remains unclear. In this review, we assess the extent to which National HIV and NCD policies in East Africa reflect the calls for HIV-NCD service integration. METHODS: Between April 2018 and December 2020, we searched for policies, strategies and guidelines associated with HIV and NCDs programmes in Burundi, Kenya, Rwanda, South Sudan, Tanzania and Uganda. Documents were searched manually for plans for integration of HIV and NCD services. Data were analysed qualitatively using document analysis. RESULTS: Thirty-one documents were screened, and 13 contained action plans for HIV and NCDs service integration. Integrated delivery of HIV and NCD care is recommended in high level health policies and treatment guidelines in four countries in the East African region; Kenya, Rwanda, Tanzania and Uganda, mostly relating to integrating NCD care into HIV programmes. The increasing burden of NCDs, as well as a move towards person-centred differentiated delivery of services for people living with HIV, is a factor in the recent adoption of integrated HIV and NCD service delivery plans. Both South Sudan and Burundi report a focus on building their healthcare infrastructure and improving coverage and quality of healthcare provision, with no reported plans for HIV and NCD care integration. CONCLUSION: Despite the limited evidence of effectiveness, some East African countries have already taken steps towards HIV and NCD service integration. Close monitoring and evaluation of the integrated HIV and NCD programmes is necessary to provide insight into the associated benefits and risks, and to inform future service developments. BMJ Publishing Group 2021-05-04 /pmc/articles/PMC8098934/ /pubmed/33947706 http://dx.doi.org/10.1136/bmjgh-2020-004669 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Original Research
Adeyemi, Olukemi
Lyons, Mary
Njim, Tsi
Okebe, Joseph
Birungi, Josephine
Nana, Kevin
Claude Mbanya, Jean
Mfinanga, Sayoki
Ramaiya, Kaushik
Jaffar, Shabbar
Garrib, Anupam
Integration of non-communicable disease and HIV/AIDS management: a review of healthcare policies and plans in East Africa
title Integration of non-communicable disease and HIV/AIDS management: a review of healthcare policies and plans in East Africa
title_full Integration of non-communicable disease and HIV/AIDS management: a review of healthcare policies and plans in East Africa
title_fullStr Integration of non-communicable disease and HIV/AIDS management: a review of healthcare policies and plans in East Africa
title_full_unstemmed Integration of non-communicable disease and HIV/AIDS management: a review of healthcare policies and plans in East Africa
title_short Integration of non-communicable disease and HIV/AIDS management: a review of healthcare policies and plans in East Africa
title_sort integration of non-communicable disease and hiv/aids management: a review of healthcare policies and plans in east africa
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8098934/
https://www.ncbi.nlm.nih.gov/pubmed/33947706
http://dx.doi.org/10.1136/bmjgh-2020-004669
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