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Integrated NCD Care in HIV Services

The document outlines the objectives and background of integrating non-communicable disease (NCD) care into HIV service delivery units, highlighting the significant burden of NCDs globally and locally, particularly cardiovascular diseases (CVDs). It emphasizes the importance of a one-stop integrated approach for screening and managing NCDs among people living with HIV (PLHIV) to improve health outcomes and address the growing needs of this population. The document also discusses the rationale for integration, aiming to enhance service uptake and retention for both NCD and HIV care.

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7 views11 pages

Integrated NCD Care in HIV Services

The document outlines the objectives and background of integrating non-communicable disease (NCD) care into HIV service delivery units, highlighting the significant burden of NCDs globally and locally, particularly cardiovascular diseases (CVDs). It emphasizes the importance of a one-stop integrated approach for screening and managing NCDs among people living with HIV (PLHIV) to improve health outcomes and address the growing needs of this population. The document also discusses the rationale for integration, aiming to enhance service uptake and retention for both NCD and HIV care.

Uploaded by

akstahost
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Chapter 1

Introduction to Integrated NCD


care at ART service delivery
units

National Training on Management of Diabetes Mellitus


for Health officers and Nurses

1
Objectives

• Describe the NCD burden in global and local


context,
• Integrated NCD service in to HIV care
Outline
• Describe the global and national magnitude
of the NCD morbidity and mortality.

• Explain the global recommendations and


rationale of HIV & NCD integrated service

• Describe the scopes, strategic approaches


and objectives of NCD integration in to HIV
care
1.1 Background
• Non-communicable diseases (NCDs) responsible for 74% of all
deaths globally.

• Cardiovascular diseases (CVDs) representing 32% of all global


deaths

• Over three quarters of CVD deaths take place in low- and


middle-income countries.

• Disability resulting from CVD increases medical care costs,


undermines economic productivity, and decreases quality of life.

• Currently CVD is the leading cause of death in Ethiopia.


1.1 Background
• In SSA, cardiovascular diseases (CVDs) are
the most frequent causes of NCDs deaths,
responsible for approximately 13% of all
deaths and 37% of all NCDs deaths.

• Ischemic heart disease (IHD) has been


identified as the leading cause of CVDs
mortality in SSA followed by stroke and
hypertensive heart disease from statistical
models.

5
Cardiovascular Disease in
People Living with HIV (2)
• Because of a combination of traditional risk factors,
HIV-related inflammation, opportunistic infections,
and highly active antiretroviral therapy (ART).

• HIV has slowly become a chronic disease.

• Thus, a one-stop integrated approach of


proactively screening for CVDs and their risk
factors during attendance at HIV clinics might
prove to be highly beneficial and economical.
Cardiovascular Disease in
People Living with HIV (2)
• People living with HIV (PLHIV) have a life expectancy that is
approaching that of the general population.

• There hasn‘t been a routine system for routine screening of NCDs


among PLHIV on follow-up.

• Integration of screening, prevention, and treatment service of selected


NCDs (Hypertension, Diabetes Mellitus ) for PLHIV will address the
growing needs of PLHIV and generate much needed evidence based
data for future policy development and system improvement.
Cardiovascular Disease in
People Living with HIV (2)
• In 2021, ICAP in Ethiopia conducted a retrospective
chart review for NCD among adult HIV patients on
follow up at selected 18 in 4 regions.

• The occurrence of hypertension, CVD,


Hyperlipidemia and DM from the review based on
documented diagnosis on the charts were 8.2%,
1.2%, 1.5% and 5.3% respectively among PLHIV
ages >40 who are on ART.

• Regional and gender-based variations were also


evidenced.

8
1.2 Rationale for NCD and HIV Services Integration

• People living with HIV (PLHIV) are living


longer, while AIDS-related mortality is
declining
• Aging places them at risk of developing
non-communicable diseases (NCDs)
• Through integration of NCD services to
HIV care we aim to improve uptake of
both NCD and HIV services, enhance
retention and improve health outcomes.
1.3 Scope of the
Implementation/Approach
• ART clinic based, client focused and less intensive
integration of NCD screening, prevention and
treatment for PLHIV.

• Clients with complicated cases will be


referred to appropriate specialized service
within the HF (specialized NCD care units)
or outside the HF to where there is
specialized service.
Thank You

11

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