Critical Appraisal of the Chronic care Model and its applicability in management of HIV and Comorbidities in Botswana clinics

Abstract

This study appraises the chronic care model and its application in management of HIV and comorbidity in Botswana clinics. HIV/AIDS has transformed from a deadly disease to a manageable condition as a result of scaling up ARV. At the same time, Africa is experiencing an epidemiological transition. The emergence of Non Communicable Diseases is a challenge to Health systems. That said, HIV services are still provided through vertical programs in Sub Saharan Africa. Industrialized countries have shifted from acute care delivery to chronic care models to address chronic illnesses. This study aims to analyze applicability of such a model onto an African context. A chronic care model by Wagner 2001 is used as a framework for this analysis. The model entails several components, but for the purpose of this study only one component will be discussed, that is Delivery System Design. This is to determine the strengths and limitations of the model towards service delivery. Then a discussion on the current challenges Botswana has in dealing with HIV and comorbidities will follow. The identified challenges will form bases for a further discussion on the applicability of the model. Vertical approach to HIV has been viewed to cause imbalances in care and treatment of other diseases. As a result, more research is needed on how to improve the 'status quo' to impact on health outcomes across all diseases.