INTEGRATING HIV AND HYPERTENSION MANAGEMENT: LESSONS FROM SUBSAHARAN AFRICA

Abstract

Objective: To describe the factors affecting effective integration of HIV and Hypertension management in Sub-Saharan Africa (SSA). Design: A narrative review of published articles describing policies and case studies of various models of HIV and Hypertension integration in SSA Results: This review showed that there are various models of integration based on diseases being managed, models of care, and levels of operation. The integration model based on the models of care was the most common where successful chronic care management platforms like HIV were leveraged to implement an integrated chronic care management model. Health system factors (medical products, health workforce, and finance) and community factors such as transportation costs, HIV stigma, socio-economic status, and utilization of traditional healers had an impact on the implementation and upscale of an integrated HIV/HTN management (IHHM). Overall, there was a net positive effect of HIV/HTN integration on the clinical outcomes of patients. Conclusion: The model of care which was more widely used with positive clinical outcomes and fewer challenges was the integration of HIV and/or HTN care into primary care clinics. This model leveraged existing infrastructure (HIV platform) to improve the hypertension care capability of workers who have previously supported unilateral HIV programs. This review also demonstrated that effective IHHM is feasible and can serve as an integrated Chronic disease model to inform national scale-up for other chronic diseases.