Integrated Management of HIV and NCDs within the Primary Health Care in the South African Context: A Comprehensive Literature Review

Nthuseni Sharon Murudi-Manganye,Lufuno Makhado,Leepile Alfred Sehularo

doi:10.2174/1874944502013010447

Abstract

Introduction Low and middle-income countries, including South Africa, are facing a challenge of the dual burden of chronic communicable and non-communicable diseases, which again pose a challenge to the improvement of patients’ clinical outcomes in the primary health care facilities. The introduction of innovative intervention to address the dual burden in South Africa created a challenge on nurses working at primary health care facilities to acquire a new set of skills to improve patients’ clinical outcomes. HIV programmes have shown great improvement in patients with HIV. However, there is still much to be done to improve NCD management. The aim of this review was to understand the status of integrated management of HIV and NCDs in South Africa and document the strengths and opportunities to sustain the implementation of integrated management of HIV and NCDs in PHC facilities in South Africa. Methodology: A comprehensive literature review of integrated management of HIV and NCDs in South Africa was conducted and complemented with a hand search literature in the form of policy documents and guidelines that were obtained from the National Department of Health. Results: A total of 17 out of 183 documents were analysed. Various strengths and opportunities, such as availability of approved guidelines and standardised training for nurses, are essential for the sustainability of integrated management of HIV and NCDs in Primary Health care facilities in South Africa. Conclusion: The CLR revealed that South Africa has strengths and opportunities which can be used to sustain integrated management of HIV and NCDs at PHC facilities and develop a model to strengthen the implementation of integrated management of HIV and NCDs in other provinces with minimal resources.

Highlights

Low and middle-income countries, including South Africa, are facing a challenge of the dual burden of chronic communicable and noncommunicable diseases, which again pose a challenge to the improvement of patients’ clinical outcomes in the primary health care facilities
A parallel synthesis was used to analyse quantitative and qualitative studies, policies, and guidelines. the following analysis questions were used to analyse and synthesise information, 1) In what ways have the researchers and policymakers addressed the integrated management of Human Immunodeficiency Virus (HIV) and NonCommunicable Diseases (NCDs) among nurses in the primary health care (PHC) setting in South Africa? 2) What are the strengths and opportunities that can be used to strengthen the implementation of integrated management HIV and NCDs among nurse-initiated and managed antiretroviral treatment (NIMART)/Adult Primary Care (APC) nurses in South Africa? The studies, policies and guidelines which were included were clustered and organized into strengths and opportunities to sustain the implementation of integrated management of HIV and NCDs in South Africa
The changing of PC 101 into Adult Primary Care (APC) in 2014 gained prominence in the country as nurses working at PHC level began to integrate the management of patients with multi-morbidity, nurses’ knowledge on providing HIV and NCDs services was found to be improving [3]

Summary

Introduction

Low and middle-income countries, including South Africa, are facing a challenge of the dual burden of chronic communicable and noncommunicable diseases, which again pose a challenge to the improvement of patients’ clinical outcomes in the primary health care facilities. The introduction of innovative intervention to address the dual burden in South Africa created a challenge on nurses working at primary health care facilities to acquire a new set of skills to improve patients’ clinical outcomes. Integrated management of chronic diseases enables primary health care (PHC) and public health to re-orientate services provided at facilities to focus on improving patient clinical outcomes through using. Strengthening training and mentoring of the health workforce, nurses on the prevention and control of NCDs is of great importance [7]

Objectives

Methods

Discussion

Conclusion