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Shayo, E, Kivuyo, S, Seeley, J, Bukenya, D, Karoli, P, Mfinanga, S, Jaffar, S and Van Hout, MC (2022) The acceptability of integrated healthcare services for HIV and non-communicable diseases: Experiences from patients and healthcare workers in Tanzania. BMC Health Services Research, 22 (1). ISSN 1472-6963
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Abstract
Background: In sub-Saharan Africa, the prevalence of non-communicable diseases (NCDs) has risen sharply amidst a high burden of communicable diseases. An integrated approach to HIV and NCD care offers the potential of strengthening disease control programmes. We used qualitative methods to explore patients’ and care-providers’ experiences and perspectives on the acceptability of integrated care for HIV-infection, diabetes mellitus (DM), and hypertension (HT) in Tanzania. Methods: A qualitative study was conducted in selected health facilities in Dar es Salaam and Coastal regions, which had started to provide integrated care and management for HIV, DM, and HT using a single research clinic for patients with one or more of these conditions. In-depth interviews were held with patients and healthcare providers at three time points: At enrolment (prior to the patient receiving integrated care, at the mid-line and at the study end). A minimum of 16 patients and 12 healthcare providers were sampled for each time point. Observation was also carried out in the respective clinics during pre- and mid-line phases. The Theoretical Framework of Acceptability (TFA) underpinned the structure and interpretation of the combined qualitative and observational data sets. Results: Patients and healthcare providers revealed a positive attitude towards the integrated care delivery model at the mid-line and at study end-time points. High acceptability was related to increased exposure to service integration in terms of satisfaction with the clinic setup, seating arrangements and the provision of medical care services. Satisfaction also centred on the patients’ freedom to move from one service point to another, and to discuss the services and their own health status amongst themselves. Adherence to medication and scheduling of clinic appointments appeared central to the patient-provider relationship as an aspect in the provision of quality services. Multi-condition health education, patient time and cost-saving, and detection of undiagnosed disease conditions emerged as benefits. On the other hand, a few challenges included long waiting times and limited privacy in lower and periphery health facilities due to infrastructural limitations. Conclusion: The study reveals a continued high level of acceptability of the integrated care model among study participants in Tanzania. This calls for evaluation in a larger and a comparative study. Nevertheless, much more concerted efforts are necessary to address structural challenges and maximise privacy and confidentiality.
| Item Type: | Article |
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| Uncontrolled Keywords: | Humans; HIV Infections; Hypertension; Diabetes Mellitus; Health Personnel; Delivery of Health Care, Integrated; Patient Acceptance of Health Care; Tanzania; Noncommunicable Diseases; Acceptability; HIV; NCD; integrated care; Non-communicable diseases; Patients; Providers; Tanzania; Delivery of Health Care, Integrated; Diabetes Mellitus; HIV Infections; Health Personnel; Humans; Hypertension; Noncommunicable Diseases; Patient Acceptance of Health Care; Tanzania; Health Policy & Services; 0807 Library and Information Studies; 1110 Nursing; 1117 Public Health and Health Services |
| Subjects: | R Medicine > RA Public aspects of medicine R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine > RA0440 Study and Teaching. Research |
| Divisions: | Public Health Institute |
| Publisher: | Springer Science and Business Media LLC |
| SWORD Depositor: | A Symplectic |
| Date Deposited: | 25 Jul 2022 09:17 |
| Last Modified: | 25 Jul 2022 09:30 |
| DOI or ID number: | 10.1186/s12913-022-08065-4 |
| URI: | https://researchonline.ljmu.ac.uk/id/eprint/17265 |
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