Integrating care for non-communicable diseases into routine HIV services: key considerations for policy design in sub-Saharan Africa

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dc.contributor.authorKintu, Alexander
dc.contributor.authorSando, David
dc.contributor.authorOkello, Samson
dc.contributor.authorMutungi, Gerald
dc.contributor.authorGuwatudde, David
dc.contributor.authorMenzies, Nicolas A.
dc.contributor.authorDanaei, Goodarz
dc.contributor.authorVerguet, Stephane
dc.date.accessioned2022-02-25T10:29:16Z
dc.date.available2022-02-25T10:29:16Z
dc.date.issued2020
dc.description.abstractThere is great interest for integrating care for non-communicable diseases (NCDs) into routine HIV services in sub-Saharan Africa (SSA) due to the steady rise of the number of people who are ageing with HIV. Suggested health system approaches for intervening on these comorbidities have mostly been normative, with little actionable guidance on implementation, and on the practical, economic and ethical considerations of favouring people living with HIV (PLHIV) versus targeting the general population. We summarize opportunities and challenges related to leveraging HIV treatment platforms to address NCDs among PLHIV. We emphasize key considerations that can guide integrated care in SSA and point to possible interventions for implementation. Discussion: Integrating care offers an opportunity for effective delivery of NCD services to PLHIV, but may be viewed to unfairly ignore the larger number of NCD cases in the general population. Integration can also help maintain the substantial health and economic benefits that have been achieved by the global HIV/AIDS response. Implementing interventions for integrated care will require assessing the prevalence of common NCDs among PLHIV, which can be achieved via increased screening during routine HIV care. Successful integration will also necessitate earmarking funds for NCD interventions in national budgets. Conclusions: An expanded agenda for addressing HIV-NCD comorbidities in SSA may require adding selected NCDs to conditions that are routinely monitored in PLHIV. Attention should be given to mitigating potential tradeoffs in the quality of HIV services that may result from the extra responsibilities borne by HIV health workers. Integrated care will more likely be effective in the context of concurrent health system reforms that address NCDs in the general population, and with synergies with other HIV investments that have been used to strengthen health systems.en_US
dc.identifier.citationKintu, A., Sando, D., Okello, S., Mutungi, G., Guwatudde, D., Menzies, NA, ... & Verguet, S. (2020). Integrating care for non‐communicable diseases into routine HIV services: key considerations for policy design in sub‐Saharan Africa. Journal of the International AIDS Society , 23 , e25508. https://doi.org/10.1002/jia2.25508en_US
dc.identifier.urihttps://doi.org/10.1002/jia2.25508
dc.identifier.urihttps://nru.uncst.go.ug/xmlui/handle/123456789/2310
dc.language.isoenen_US
dc.publisherJournal of the International AIDS Societyen_US
dc.subjectHIV/AIDSen_US
dc.subjectNon-communicable diseasesen_US
dc.subjectAntiretroviral therapyen_US
dc.subjectIntegrated careen_US
dc.subjectSub-Saharan Africaen_US
dc.titleIntegrating care for non-communicable diseases into routine HIV services: key considerations for policy design in sub-Saharan Africaen_US
dc.typeArticleen_US
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