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.