Factors hindering integration of care for non-communicable diseases within HIV care services in Dar es Salaam, Tanzania: The perspectives of health workers and people living with HIV.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2021
2021
Historique:
received:
04
02
2021
accepted:
26
06
2021
entrez:
12
8
2021
pubmed:
13
8
2021
medline:
24
11
2021
Statut:
epublish
Résumé
Global mortality attributable to non-communicable diseases (NCDs) occurs in more than 36 million people annually with 80% of these deaths occurring in resource limited countries. Among people living with HIV and AIDS (PLHA) studies have reported higher prevalence's of NCDs compared to the general population but most studies do report a narrow range of NCDs commonly hypertension, diabetes and neoplasms and not all. In addition, there is limited reporting, integration of systematic screening and treatment for all NCDs among PLHA attending care, suggesting the NCD burden among PLHA is likely an underestimate. Little is known about factors facilitating or hindering integration of the care and treatment of NCDs within HIV care and treatment clinics (CTCs) in Tanzania. To explore the perceptions of PLHA and health workers on factors facilitate or hinder the recognition and integration of care for NCDs within CTCs in Dar es Salaam. Inductive content analysis of transcripts from 41 in-depth interviews were conducted with 5 CTC managers (CTC Managers), 9 healthcare providers (DHCP) and 27 people living with HIV (PLHA) attending CTCs and with co-morbid NCDs. Four themes emerged; the current situation of services available for care and treatment of NCDs among PLHA in CTCs, experiences of PLHA with co-morbid NCDs with access to care and treatment services for NCDs, facilitators of integrating care and treatment of NCDs within CTCs and perceived barriers for accessing and integration of care and treatment of NCDs within CTCs. There was a positive attitude among PLHA and healthcare workers towards integration of NCD services within CTC services. This was enhanced by perceived benefits inherent to the services. Factors hindering integration of NCD care and services included; limited and inconsistent supplies such as screening equipment, medications; insufficient awareness of NCDs within PLHA; lack of adequate training of healthcare workers on management of NCD and treatment costs and payment systems.
Sections du résumé
BACKGROUND
Global mortality attributable to non-communicable diseases (NCDs) occurs in more than 36 million people annually with 80% of these deaths occurring in resource limited countries. Among people living with HIV and AIDS (PLHA) studies have reported higher prevalence's of NCDs compared to the general population but most studies do report a narrow range of NCDs commonly hypertension, diabetes and neoplasms and not all. In addition, there is limited reporting, integration of systematic screening and treatment for all NCDs among PLHA attending care, suggesting the NCD burden among PLHA is likely an underestimate. Little is known about factors facilitating or hindering integration of the care and treatment of NCDs within HIV care and treatment clinics (CTCs) in Tanzania.
OBJECTIVE
To explore the perceptions of PLHA and health workers on factors facilitate or hinder the recognition and integration of care for NCDs within CTCs in Dar es Salaam.
METHODS
Inductive content analysis of transcripts from 41 in-depth interviews were conducted with 5 CTC managers (CTC Managers), 9 healthcare providers (DHCP) and 27 people living with HIV (PLHA) attending CTCs and with co-morbid NCDs.
RESULTS
Four themes emerged; the current situation of services available for care and treatment of NCDs among PLHA in CTCs, experiences of PLHA with co-morbid NCDs with access to care and treatment services for NCDs, facilitators of integrating care and treatment of NCDs within CTCs and perceived barriers for accessing and integration of care and treatment of NCDs within CTCs.
CONCLUSIONS
There was a positive attitude among PLHA and healthcare workers towards integration of NCD services within CTC services. This was enhanced by perceived benefits inherent to the services. Factors hindering integration of NCD care and services included; limited and inconsistent supplies such as screening equipment, medications; insufficient awareness of NCDs within PLHA; lack of adequate training of healthcare workers on management of NCD and treatment costs and payment systems.
Identifiants
pubmed: 34383765
doi: 10.1371/journal.pone.0254436
pii: PONE-D-21-03870
pmc: PMC8360604
doi:
Types de publication
Clinical Trial
Journal Article
Observational Study
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0254436Subventions
Organisme : FIC NIH HHS
ID : D43 TW009775
Pays : United States
Organisme : HRSA HHS
Pays : United States
Organisme : PEPFAR
Pays : United States
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
J Adv Nurs. 2008 Apr;62(1):107-15
pubmed: 18352969
BMC Public Health. 2017 Apr 5;17(1):297
pubmed: 28381252
Int J Infect Dis. 2013 Oct;17(10):e820-31
pubmed: 23953699
BMC Public Health. 2019 Apr 3;19(1):372
pubmed: 30943975
AIDS. 2018 Jul 1;32 Suppl 1:S5-S20
pubmed: 29952786
BMJ. 2020 Jan 28;368:m141
pubmed: 31992592
Trop Med Int Health. 2017 Aug;22(8):926-937
pubmed: 28544500
PLoS One. 2019 Aug 9;14(8):e0221022
pubmed: 31398244
Nurse Educ Today. 2004 Feb;24(2):105-12
pubmed: 14769454
Nurse Res. 2011;18(3):6-12
pubmed: 21560920
Lancet. 2013 Nov 2;382(9903):1525-33
pubmed: 24152939
BMC Public Health. 2014 Sep 02;14:904
pubmed: 25183300