2 research outputs found
Opportunities and challenges for evidence-informed HIV-noncommunicable disease integrated care policies and programs : Lessons from Malawi, South Africa, Swaziland and Kenya
Introduction: Countries in sub-Saharan Africa (SSA) are recognizing the growing dual burden of HIV and noncommunicable diseases (NCDs). This article explores the availability, implementation processes, opportunities and challenges for policies and programs for HIV/NCD integration in four SSA countries: Malawi, Kenya, South Africa and Swaziland. Methods: We conducted a cross-sectional analysis of current policies and programs relating to HIV/NCD care integration from January to April 2017 using document review and expert opinions. The review focussed on availability and content of relevant policy documents and processes towards implementating national HIV/NCD integration policies. Results: All four case study countries had at least one policy document including aspects of HIV/NCD care integration. Apart from South Africa that had a phased nation-wide implementation of a comprehensive integrated chronic disease model, the three other countries - Malawi, Kenya and Swaziland, had either pilot implementations or nation-wide single-disease integration of NCDs and HIV. Opportunities for HIV/NCD integration policies included: presence of overarching health policy documents that recognize the need for integration, and coordinated action by policymakers, researchers and implementers. Evidence gaps for cost-effectiveness, effects of integration on key HIV and NCD outcomes and funding mechanisms for sustained implementation of integrated HIV/NCD care strategies, were among challenges identified. Conclusion: Policymakers in Malawi, Kenya, South Africa and Swaziland have considered integration of NCD and HIV care but a lack of robust evidence hampers large-scale implementation of HIV/NCD integration. It is crucial for SSA Ministries of Health and throughout low-and-middle-income countries to utilize existing opportunities and advocate for evidence-informed HIV/NCD integration strategies
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The Lancet NCDI Poverty Commission: bridging a gap in universal health coverage for the poorest billion
For the poorest of our world, non-communicable diseases
and injuries (NCDIs) account for more than a third of their
burden of disease; this burden includes almost
800000 deaths annually among those aged younger than
40 years, more than HIV, tuberculosis, and maternal
deaths combined.
• Despite already living in abject poverty, between
19 million and 50 million of the poorest billion spend a
catastrophic amount of money each year in direct
out-of-pocket costs on health care as a result of NCDIs.
• Progressive implementation of affordable, cost-effective,
and equitable NCDI interventions between 2020 and 2030
could save the lives of more than 4·6 million of the world’s
poorest, including 1·3 million who would otherwise die
before the age of 40 years.
• To avoid needless death and suffering, and to reduce the
risk of catastrophic health spending, essential NCDI
services must be financed through pooled, public
resources, either from increased domestic funding or
external funds.
• National governments should set and adjust priorities
based on the best available local data on NCDIs and the
specific needs of the worst off.
• International development assistance for health should
be augmented and targeted to ensure that the poorest
families affected by NCDIs are included in progress
towards universal health care