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从撒哈拉以南非洲艾滋病毒和非传染性疾病医疗保健一体化中吸取的教训。

Lessons Learnt from HIV and Noncommunicable Disease Healthcare Integration in Sub-Saharan Africa.

机构信息

Julius Global Health, Department of Global Public Health and Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.

Division of Biology of Disease, Department of Biomedical Sciences, Faculty of Medicine, Utrecht University, Utrecht, the Netherlands.

出版信息

Glob Heart. 2024 Nov 12;19(1):85. doi: 10.5334/gh.1370. eCollection 2024.

Abstract

In sub-Saharan Africa (SSA), a rising burden of noncommunicable diseases (NCDs) coexists with a persistent high burden of human immunodeficiency virus (HIV). Integrating care for chronic conditions is potentially beneficial, but the optimal approach remains unclear. By use of a narrative review of 14 recent case studies from different SSA countries, examples of NCD and HIV healthcare integration were described. Case studies were categorized into three models: integrating NCD care into existing HIV care ( = 8), integrating HIV care into existing NCD care ( = 2), and simultaneous implementation of HIV and NCD services ( = 4). Facilitators include staff and patient education, while barriers encompass the lack of guidelines and inadequate infrastructure. Providers, patients, and policymakers support integrated care but note several challenges. Available health economics data suggest cost-effectiveness in the long run. Concluding, NCD and HIV healthcare integration in SSA was deemed feasible with models of service integration related to the implementation context.

摘要

在撒哈拉以南非洲(SSA),不断增加的非传染性疾病(NCD)负担与持续高负担的人类免疫缺陷病毒(HIV)并存。整合慢性病护理具有潜在的益处,但最佳方法仍不清楚。通过对来自不同 SSA 国家的 14 项最近案例研究的叙述性回顾,描述了 NCD 和 HIV 医疗保健整合的例子。案例研究分为三种模式:将 NCD 护理纳入现有的 HIV 护理中(= 8),将 HIV 护理纳入现有的 NCD 护理中(= 2),以及同时实施 HIV 和 NCD 服务(= 4)。促进因素包括工作人员和患者教育,而障碍包括缺乏指南和基础设施不足。提供者、患者和政策制定者支持综合护理,但指出了几个挑战。现有的卫生经济学数据表明,从长远来看具有成本效益。总之,SSA 的 NCD 和 HIV 医疗保健整合被认为是可行的,服务整合模式与实施背景有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4959/11568807/7d66c5013480/gh-19-1-1370-g1.jpg

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