Integrated management of HIV/NCDs: knowledge, attitudes, and practices of health care workers in Gaborone, Botswana

Abstract

Background: The epidemiologic transition and double disease burden from chronic infections and Non-communicable diseases (NCDs) worldwide requires re-engineering of healthcare delivery systems. Healthcare workers (HCWs) need to adapt to new integrated disease management approaches and change from current disease-specific management. Objectives: The study aimed to determine HCWs knowledge, capacity and skills for management of NCDs among HIV patients and their attitudes towards integrated HIV/NCDs disease management approaches for future clinical practice. Methods: Descriptive cross-sectional survey among HCWs attending to HIV patients at selected government facilities. Results: One hundred out of 105 responses were analysed. Only 6% could fully define NCDs. Awareness levels of NCDs were high: Diabetes and hypertension 98%; cancer 96%; cardiovascular diseases 86%. However, 11.8% and 58% classified HIV and malaria respectively as NCDs. Most respondents (88%) believe that integrating HIV/NCDs care would be good use of resources while 62% disagreed with current separate facility management of HIV patients with NCDs. Over 60% routinely screened HIV patients for NCDs risk factors: Smoking (87.2%), alcohol (90.8%), diet (84.9%) and physical activity (73.5%). Conclusion: There were gaps in detailed knowledge on NCDs, but positive attitude towards routine primary care integrated HIV/NCDs management, showing likely support for implementation of such policy.Keywords: Non-communicable diseases, knowledge, attitude, HIV, integration.

Exploration of NIMART-trained nurses’ experiences in the implementation of integrated management of HIV and NCDs in Limpopo Province, South Africa

“…Progress on the integrated management of HIV and NCDs is continuously reported in the 27 districts, which are PEPFAR supported [2,40,41]. Also, most countries have published research on integrated management of HIV and NCDs, and reported that the research was donor-funded [40][41][42][43][44][45].…”

HIV- related knowledge, attitude, practices, and stigma among healthcare providers caring for HIV in Jordan: Identification of several organizational challenges

“…We developed a semi-structured interview guide, with questions and relevant probes adapted from previous studies [ 12 , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] ], Appendix 1 . Interviewers were encouraged to attend to emergent themes as appropriate.…”

Women living with HIV, diabetes and/or hypertension multi-morbidity in Uganda: a qualitative exploration of experiences accessing an integrated care service

“…Funding for services, medicines supply and robust research evidence to inform NCD and multi-morbid health policy is still developing (Katende et al, 2015;Manne-Goehler et al, 2016;Price et al, 2018). Conditions such as diabetes and hypertension, and HIV require lifelong care, with integrated care of these conditions garnering increased interest amongst policy makers, scientists and academics in many sub-Saharan African countries (Edwards et al, 2015;Divala et al, 2016;Some et al, 2016;Ameh et al, 2016Ameh et al, , 2017Golovaty et al, 2018;Haldane et al, 2018;Juma et al, 2018;Masupe et al, 2019;Iwelunmor et al, 2019;Kwarisiima et al, 2019;Kintu et al, 2020). Integrated care is defined as "the coordination, colocation or simultaneous delivery of communicable and noncommunicable services to patients who need it, when they need it" (Vorkoper et al, 2019;Singh et al, 2021: p2) and has become a well-received intervention in sub-Saharan Africa when targeting PLHIV and people living with NCDs (Duffy et al, 2017;Singh et al, 2021).…”