Original Research

You can treat my HIV – But can you treat my blood pressure? Availability of integrated HIV and non-communicable disease care in northern Malawi

Colin Pfaff, Vera Scott, Risa Hoffman, Beatrice Mwagomba
African Journal of Primary Health Care & Family Medicine | Vol 9, No 1 | a1151 | DOI: https://doi.org/10.4102/phcfm.v9i1.1151 | © 2017 Colin Pfaff, Vera Scott, Risa Hoffman, Beatrice Mwagomba | This work is licensed under CC Attribution 4.0
Submitted: 21 January 2016 | Published: 15 February 2017

About the author(s)

Colin Pfaff, Partners in Hope Medical Center, Lilongwe, Malawi
Vera Scott, School of Public Health, University of Western Cape, South Africa
Risa Hoffman, Department of Medicine and Division of Infectious Diseases, David Geffen School of Medicine at UCLA, United States
Beatrice Mwagomba, University of St Andrews, Scotland, United Kingdom; College of Medicine, University of Malawi, Blantyre, Malawi; NCD Unit, Ministry of Health, Malawi


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Abstract

Background: Many patients on antiretroviral therapy (ART) in Malawi have or will develop non-communicable diseases (NCDs). The current capacity of ART sites to provide care for NCDs is not known.
Aim: This study aimed to assess the capacity of ART sites to provide care for hypertension and diabetes in rural Malawi.
Setting: Twenty-five health centres and five hospitals in two rural districts in northern Malawi.
Methods: A cross-sectional survey was performed between March and May 2014 at all facilities. Qualitative interviews were held with three NCD coordinators.
Results: Treatment of hypertension and diabetes was predominantly hospital-based. Sixty percent of hospitals had at least one clinician and one nurse trained in NCD care, whereas 5% of health centres had a clinician and 8% had a nurse trained in NCD care. Hundred percent of hospitals and 92% of health centres had uninterrupted supply of hydrochlorothiazide in the previous 6 months, but only 40% of hospitals and no health centres had uninterrupted supply of metformin. Hundred percent of hospitals and 80% of health centres had at least one blood pressure machine, and 80% of hospitals and 32% of health centres had one glucometer. Screening for hypertension amongst ART patients was only conducted at one hospital and no health centres. At health centres, integrated NCD and ART care was more common, with 48% (12/25) providing ART and NCD treatment in the same consultation.
Conclusions: The results reflect the status of the initial stages of the Malawi NCD programme at sites currently providing ART care.

 


Keywords

hiv; hypertension; diabetes; chronic care

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