Maternal and Child Health Investment Program, Ministry of Health, Dodoma, Tanzania.
School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
HIV Res Clin Pract. 2024 Dec;25(1):2398869. doi: 10.1080/25787489.2024.2398869. Epub 2024 Sep 5.
People living with HIV and non-communicable diseases (NCDs) are reported to experience challenges in accessing affordable and high-quality NCD care services. Consequently, the World Health Organization (WHO) recommends care integration of NCDs within the HIV services in resource-limited regions. The available opportunities and challenges need to be understood and addressed for an effective integration process. This study explored opportunities and challenges for integrating NCDs within HIV care and treatment services in Tanzania.
An exploratory qualitative case study was conducted in Tanzania between April and July 2022. A total of 22 key informants working at the ministerial level, supervising the provision of healthcare services in Tanzania, were recruited purposefully for in-depth interviews. Thematic analysis was employed during the study.
Several opportunities were identified in the study for HIV/NCD services integration including the existence of an integration policy, the availability of regulations and guidelines, the existence of donor support, the presence of physical space and reliable information and communication systems, human resources adequacy, and political will to support the process. However, participants voiced concerns over the costs related to service integration, difficulties in reallocating donor funds, and hesitance of the healthcare providers as likely challenges to effective integration.
The findings of this study underscore that the effective and sustainable care integration of NCDs within HIV services relies on the availability of policy, funds, infrastructures, human resources, and stakeholders' willingness to support the process.
据报道，艾滋病毒感染者和非传染性疾病（NCDs）患者在获得负担得起和高质量的 NCD 护理服务方面面临挑战。因此，世界卫生组织（WHO）建议在资源有限的地区将 NCD 护理纳入 HIV 服务中。需要了解和解决现有机会和挑战，以实现有效的整合过程。本研究探讨了在坦桑尼亚将 NCD 纳入 HIV 护理和治疗服务中的机会和挑战。
2022 年 4 月至 7 月，在坦桑尼亚进行了一项探索性定性案例研究。共有 22 名在部级工作的主要信息提供者，负责监督坦桑尼亚医疗保健服务的提供，他们被有目的地招募进行深入访谈。在研究过程中采用了主题分析。
研究中发现了一些 HIV/NCD 服务整合的机会，包括整合政策的存在、法规和指南的可用性、捐助者支持的存在、物理空间和可靠的信息和通信系统的存在、人力资源充足以及支持该过程的政治意愿。然而，参与者对与服务整合相关的成本、重新分配捐助资金的困难以及医疗保健提供者的犹豫表示担忧，这些可能是有效整合的挑战。
本研究的结果强调，要实现 NCD 与 HIV 服务的有效和可持续整合，需要有政策、资金、基础设施、人力资源以及利益相关者支持该过程的意愿。
