A Framework for Implementing Integrated HIV and Non-Communicable Disease Care at Primary Health Care Facilities in Southern Africa

在南部非洲基层医疗机构实施艾滋病毒和非传染性疾病综合护理的框架

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Abstract

INTRODUCTION: Comorbidities of HIV/AIDS and non-communicable diseases (NCDs) are increasingly prevalent, affecting up to 30% of individuals living with HIV/AIDS, particularly in Sub-Saharan Africa. Conventional approaches that treat NCDs separately from HIV/AIDS care have been deemed inefficient, highlighting the need for integrated models. This study aims to develop a framework for integrating NCD care into HIV programs at primary healthcare facilities in Southern Africa. METHODS: As part of a broader study examining the burden, extent and cost of HIV/NCD integration we employed a modified 'Best fit' framework synthesis method. Thematic analysis was the primary method of analysis used to inform the framework. RESULTS: The study expanded on existing framework themes related to effective team-working, organizational leadership, patient-centered care, community/patient/provider partnerships. It introduced seven additional themes: country specific NCD prioritization, multi stakeholder partnerships, healthcare worker mental wellbeing, unified health information systems, with enhanced privacy, establishing costing databases for HIV/NCD integrated care, robust monitoring and evaluation mechanisms, and opportunities for regional coordination. CONCLUSION: Improving existing frameworks for integrating HIV/NCD care is feasible by leveraging established HIV care platforms. These enhancements can support more efficient holistic healthcare delivery across primary healthcare facilities in Southern Africa.

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