Department of Epidemiology and Clinical Research, Rakai Health Sciences Program, Kalisizo, Kyotera, Uganda.
Department of Science and Grants, African Medical and Behavioral Sciences Organization, Nansana, Wakiso, Uganda.
PLoS One. 2024 Aug 20;19(8):e0302290. doi: 10.1371/journal.pone.0302290. eCollection 2024.
Non-communicable diseases are highly prevalent among adults living with HIV, emphasizing the need for comprehensive healthcare strategies. However, a dearth of knowledge exists regarding the health systems challenges in managing HIV and non-communicable diseases and the perception of health workers regarding the integrated management of non-communicable diseases during routine HIV care in rural Ugandan settings. This study aims to bridge this knowledge gap by exploring the health system challenges in managing HIV and non-communicable diseases and health workers' perception regarding the integration of non-communicable diseases in routine HIV care in South Central Uganda.
In this qualitative study, we collected data from 20 purposively selected key informants from Kalisizo Hospital and Rakai Hospital in South Central Uganda. Data were collected from 15th December 2020 and 14th January 2021. Data were analyzed using a thematic content approach with the help of NVivo 11.
Of the 20 health workers, 13 were females. In terms of work duration, 9 had worked with people living with HIV for 11-15 years and 9 were nurses. The challenges in managing HIV and non-communicable diseases included difficulty managing adverse events, heavy workload, inadequate communication from specialists to lower cadre health workers, limited financial and human resources, unsupportive clinical guidelines that do not incorporate non-communicable disease management in HIV care and treatment, and inadequate knowledge and skills required to manage non-communicable diseases appropriately. Health workers suggested integrating non-communicable disease management into routine HIV care and suggested the need for training before this integration.
The integration of non-communicable disease management into routine HIV care presents a promising avenue for easing the burden on health workers handling these conditions. However, achieving successful integration requires not only the training of health workers but also ensuring the availability of sufficient human and financial resources.
非传染性疾病在感染艾滋病毒的成年人中高发，这强调了需要采取全面的医疗保健策略。然而，在管理艾滋病毒和非传染性疾病方面的卫生系统挑战以及卫生工作者对在乌干达农村地区常规艾滋病毒护理中整合非传染性疾病管理的看法方面，知识匮乏。本研究旨在通过探索在管理艾滋病毒和非传染性疾病方面的卫生系统挑战以及卫生工作者对在南乌干达常规艾滋病毒护理中整合非传染性疾病管理的看法，来填补这一知识空白。
在这项定性研究中，我们从乌干达中南部的卡利西索医院和拉凯医院中选择了 20 名有目的的关键信息提供者收集数据。数据于 2020 年 12 月 15 日至 2021 年 1 月 14 日收集。使用 NVivo 11 帮助的主题内容方法分析数据。
在 20 名卫生工作者中，有 13 名是女性。在工作年限方面，有 9 人从事艾滋病毒感染者护理工作 11-15 年，有 9 人是护士。管理艾滋病毒和非传染性疾病的挑战包括难以管理不良事件、工作量大、专家与低级卫生工作者之间沟通不足、财务和人力资源有限、不支持的临床指南不将非传染性疾病管理纳入艾滋病毒护理和治疗以及适当管理非传染性疾病所需的知识和技能不足。卫生工作者建议将非传染性疾病管理纳入常规艾滋病毒护理，并建议在整合之前进行培训。
将非传染性疾病管理纳入常规艾滋病毒护理为减轻处理这些疾病的卫生工作者的负担提供了一个有前途的途径。然而，要实现成功整合，不仅需要培训卫生工作者，还需要确保有足够的人力和财力资源。
