Lessons Learnt from HIV and Noncommunicable Disease Healthcare Integration in Sub-Saharan Africa.

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Global Heart Pub Date : 2024-11-12 eCollection Date: 2024-01-01 DOI:10.5334/gh.1370

Jessica S van der Mannen, Martin Heine, Samanta T Lalla-Edward, Dike B Ojji, Ana O Mocumbi, Kerstin Klipstein-Grobusch

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Abstract

In sub-Saharan Africa (SSA), a rising burden of noncommunicable diseases (NCDs) coexists with a persistent high burden of human immunodeficiency virus (HIV). Integrating care for chronic conditions is potentially beneficial, but the optimal approach remains unclear. By use of a narrative review of 14 recent case studies from different SSA countries, examples of NCD and HIV healthcare integration were described. Case studies were categorized into three models: integrating NCD care into existing HIV care (n = 8), integrating HIV care into existing NCD care (n = 2), and simultaneous implementation of HIV and NCD services (n = 4). Facilitators include staff and patient education, while barriers encompass the lack of guidelines and inadequate infrastructure. Providers, patients, and policymakers support integrated care but note several challenges. Available health economics data suggest cost-effectiveness in the long run. Concluding, NCD and HIV healthcare integration in SSA was deemed feasible with models of service integration related to the implementation context.

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从撒哈拉以南非洲艾滋病毒和非传染性疾病医疗保健一体化中汲取的经验教训。

在撒哈拉以南非洲地区（SSA），非传染性疾病（NCDs）的负担不断加重，而人类免疫缺陷病毒（HIV）的负担却居高不下。整合慢性病护理可能会带来益处，但最佳方法仍不明确。通过对来自撒哈拉以南非洲地区不同国家的 14 个最新案例研究的叙述性回顾，介绍了非传染性疾病与艾滋病医疗保健相结合的实例。案例研究被分为三种模式：将 NCD 医疗服务整合到现有的 HIV 医疗服务中（n = 8），将 HIV 医疗服务整合到现有的 NCD 医疗服务中（n = 2），以及同时实施 HIV 和 NCD 服务（n = 4）。促进因素包括员工和患者教育，而障碍则包括缺乏指南和基础设施不足。医疗服务提供者、患者和政策制定者都支持综合医疗，但也注意到了一些挑战。现有的卫生经济学数据表明，从长远来看，综合护理具有成本效益。总之，在撒哈拉以南非洲地区，非传染性疾病和艾滋病毒医疗保健整合被认为是可行的，其服务整合模式与实施背景相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Global Heart Medicine-Cardiology and Cardiovascular Medicine

CiteScore

5.70

自引率

5.40%

发文量

审稿时长

5 weeks

期刊介绍： Global Heart offers a forum for dialogue and education on research, developments, trends, solutions and public health programs related to the prevention and control of cardiovascular diseases (CVDs) worldwide, with a special focus on low- and middle-income countries (LMICs). Manuscripts should address not only the extent or epidemiology of the problem, but also describe interventions to effectively control and prevent CVDs and the underlying factors. The emphasis should be on approaches applicable in settings with limited resources. Economic evaluations of successful interventions are particularly welcome. We will also consider negative findings if important. While reports of hospital or clinic-based treatments are not excluded, particularly if they have broad implications for cost-effective disease control or prevention, we give priority to papers addressing community-based activities. We encourage submissions on cardiovascular surveillance and health policies, professional education, ethical issues and technological innovations related to prevention. Global Heart is particularly interested in publishing data from updated national or regional demographic health surveys, World Health Organization or Global Burden of Disease data, large clinical disease databases or registries. Systematic reviews or meta-analyses on globally relevant topics are welcome. We will also consider clinical research that has special relevance to LMICs, e.g. using validated instruments to assess health-related quality-of-life in patients from LMICs, innovative diagnostic-therapeutic applications, real-world effectiveness clinical trials, research methods (innovative methodologic papers, with emphasis on low-cost research methods or novel application of methods in low resource settings), and papers pertaining to cardiovascular health promotion and policy (quantitative evaluation of health programs.