Tropical medicine & international health : TM & IH 2017 05 24() doi 10.1111/tmi.12901
Non-communicable diseases (NCD) are a growing cause of morbidity in low-income countries including in people living with Human Immunodeficiency Virus (HIV). Integration of NCD and HIV services can build upon experience with chronic care models from HIV programs. We describe models of NCD and HIV integration, challenges, and lessons learned.
Literature review of articles on integrated NCD and HIV programs in low-income countries and key informant interviews with leaders of identified integrated NCD and HIV programs. Information was synthesized to identify models of NCD and HIV service delivery integration.
Three models of integration were identified: NCD services integrated into centers originally providing HIV care; HIV care integrated into primary health care (PHC) already offering NCD services; and simultaneous introduction of integrated HIV and NCD services. Major challenges identified included NCD supply chain, human resources, referral systems, patient education, stigma, patient records, and monitoring and evaluation. The range of HIV and NCD services varied widely within and across models.
Regardless of model of integration, leveraging experience from HIV care models and adapting existing systems and tools is a feasible method to provide efficient care and treatment for the growing numbers of patients with NCDs. Operational research should be conducted to further study how successful models of HIV and NCD integration can be expanded in scope and scaled-up by managers and policy-makers seeking to address all the chronic care needs of their patients. This article is protected by copyright. All rights reserved.