Abstract
Tuberculosis and Human Immunodeficiency Virus epidemics in sub-Saharan Africa have been closely related and persistent, proving a considerable burden for healthcare provision. This has complicated utilization of services, with noted opinions on the integration of these services from both users and providers of the services. To establish the users and the provider's perspectives in overcoming the challenges of TB/HIV services integration at Mulago National Referral Hospital. Descriptive cross-sectional design, with predominantly qualitative methods was used. Qualitative aspect adopted phenomenological design. Participants were randomly selected for FGDs and Key informants. An observation checklist collected quantitative data from the patients to measure level of services integration. Level of service integration of TB/HIV services was at 68% (below the acceptable 100% level). Opinions from the users pointed to; increasing number of work-days for TB/HIV service provision, strengthening sensitisation and health education and integrating other services like reproductive health services, among others. Health care providers opinions pointed to increasing trainings for health workers, increasing staffing and need for more support from Ministry of Health. Opinions from both users and providers were similar. These ranged from increasing awareness to the users and healthcare providers about the integration of services.
Highlights
Background to the Study The World Health Organization (WHO) defines integrated healthcare as ‘the organization and management of health services so that people get the care they need, when they need it, in ways that are user-friendly, achieve the desired results and provide value for money 1
In 2014, the World Health Organization (WHO) reported 83% incident TB cases worldwide out of which one third of these new TB cases originated from the African continent with high burden countries (HBCs)[7]
WHO global TB report which showed that the proportion of TB cases living with Human Immunodeficiency Virus (HIV) was highest in the WHO African Region (31%) and exceeded 50% in parts of southern Africa[6,7]
Summary
Background to the Study The World Health Organization (WHO) defines integrated healthcare as ‘the organization and management of health services so that people get the care they need, when they need it, in ways that are user-friendly, achieve the desired results and provide value for money 1. The Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) pandemics in sub-Saharan Africa have been closely related and persistent, proving a considerable burden for healthcare provision and complicated the utilization of services, with. To decrease the joint burden of HIV and TB disease, the World Health Organization (WHO) formulated a strategic framework for collaborative TB/HIV activities While patients receive these services, they are faced with several challenges that need to be sorted out so that recommendations can be drawn for effective utilization of these services 6. Tuberculosis and Human Immunodeficiency Virus epidemics in sub-Saharan Africa have been closely related and persistent, proving a considerable burden for healthcare provision This has complicated utilization of services, with noted opinions on the integration of these services from both users and providers of the services.
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