Latest from INTE-AFRICA: Delphi consensus study on international best practice

Blog 8 Dec 2021
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INTE-AFRICA researchers have published “Integrating diabetes, hypertension and HIV care in sub-Saharan Africa: a Delphi consensus study on international best practice ” in BMC Health Services Research. The aim of the study was to identify key components, outcomes, and best practice in integrated service provision for the prevention, identification and treatment of HIV, hypertension and diabetes.

In the first round of this study, international experts were asked to score 27 statements in the categories ‘Service Provision’ and ‘Benefits of Integration’. In the second round, participants got to see the distribution of scores of the other participants along with their own scores and were asked if they wanted to rescore. In addition, additional outcomes were added after round one as suggested by participants.

Some examples:

For Service Provision, 100% ranked “There should be community-based education programs utilizing existing social, cultural and religious networks to proactively address stigma within NCD/HIV care” as a high priority. While 0% reported “An integrated care clinic should only deliver care to patients with multimorbidity” to be a high priority.

For Benefits of Integration, 100% of the panel agreed that: “An integrated clinic will provide better continuity of care for patients with multi-morbidities (HIV, diabetes and hypertension)”. On the other hand, only 11% agreed that “Integrated services may weaken the current HIV programme”.

Five items were considered essential by experts for effective integrated healthcare delivery of health services for chronic conditions:

  • Improved data collection and surveillance of NCDs among people living with HIV to inform integrated NCD/HIV programme management;
  • Strengthened drug procurement systems;
  • Availability of equipment and access to relevant blood tests;
  • Health education for all chronic conditions;
  • Enhanced continuity of care for patients with multimorbidity.

The outcomes of this study may form key components of future complex interventions to define a model of integrated healthcare delivery for diabetes, hypertension and HIV in sub-Saharan Africa.

This story was orginally published on the INTE-AFRICA website 03/12/2021