Care and management of a double burden of chronic diseases: Experiences of patients and perceptions of their healthcare providers
South Africa, 2014 - 2020
Nasheeta Peer, Anniza de Villiers, Deborah Jonathan, Cathy Kalombo, Andre-Pascal Kengne
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October 08, 2021
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October 08, 2021
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Identification
Survey ID Number
Careandmanagementofadoubleburdenofchronicdiseases
Title
Care and management of a double burden of chronic diseases: Experiences of patients and perceptions of their healthcare providers
Country
| Name | Country code |
|---|---|
| South Africa | ZAR |
Abstract
Aim:
The increasing burden of comorbid HIV infection and hypertension necessitates a focus on healthcare services providing care for chronic multi-morbidities. The aim of this study was to evaluate the perceptions and experiences of 1) people living with HIV infection (PLWHIV) and comorbid hypertension, and 2) their healthcare providers, related to their diagnoses and interactions with chronic healthcare services in South Africa.
Methods:
This study comprised quantitative and qualitative arms with a multi-layered approach. We randomly selected 17 public healthcare facilities providing HIV care across Cape Town and surrounding rural municipalities.
Results:
Interviews were conducted with clinicians (n=11), specialised nursing professionals (n=10), lay counsellors (n=12), six patients focus groups (n=35) and 20 in-depth individual patient interviews. There were mixed views on being treated at integrated vs. separate chronic care facilities regarding quality of care and privacy/anonymity. Specialised clinics offered better care for HIV infection while hypertension and other non-communicable diseases (NCDs) were neglected. Privacy about HIV status maybe better maintained in integrated clinics but not if status was disclosed by having the green-coloured HIV treatment card. A single appointment date was considered advantageous as it saved time and money leading to greater compliance; however, waiting times at clinics were longer with perhaps fewer patients seen.
Conclusions:
The mixed reactions elicited to the integration of healthcare services for HIV, hypertension and other non-communicable diseases highlights the complexities involved in implementing such services. Greater human resources with retraining and reskilling of healthcare staff is required for the optimal management of chronic multi-morbidities.
The increasing burden of comorbid HIV infection and hypertension necessitates a focus on healthcare services providing care for chronic multi-morbidities. The aim of this study was to evaluate the perceptions and experiences of 1) people living with HIV infection (PLWHIV) and comorbid hypertension, and 2) their healthcare providers, related to their diagnoses and interactions with chronic healthcare services in South Africa.
Methods:
This study comprised quantitative and qualitative arms with a multi-layered approach. We randomly selected 17 public healthcare facilities providing HIV care across Cape Town and surrounding rural municipalities.
Results:
Interviews were conducted with clinicians (n=11), specialised nursing professionals (n=10), lay counsellors (n=12), six patients focus groups (n=35) and 20 in-depth individual patient interviews. There were mixed views on being treated at integrated vs. separate chronic care facilities regarding quality of care and privacy/anonymity. Specialised clinics offered better care for HIV infection while hypertension and other non-communicable diseases (NCDs) were neglected. Privacy about HIV status maybe better maintained in integrated clinics but not if status was disclosed by having the green-coloured HIV treatment card. A single appointment date was considered advantageous as it saved time and money leading to greater compliance; however, waiting times at clinics were longer with perhaps fewer patients seen.
Conclusions:
The mixed reactions elicited to the integration of healthcare services for HIV, hypertension and other non-communicable diseases highlights the complexities involved in implementing such services. Greater human resources with retraining and reskilling of healthcare staff is required for the optimal management of chronic multi-morbidities.
Producers and sponsors
Primary investigators
| Name | Affiliation |
|---|---|
| Nasheeta Peer | Non-communicable Diseases Research Unit, South African Medical Research Council, Durban and Cape Town, South Africa |
| Anniza de Villiers | Non-communicable Diseases Research Unit, South African Medical Research Council, Durban and Cape Town, South Africa |
| Deborah Jonathan | Non-communicable Diseases Research Unit, South African Medical Research Council, Durban and Cape Town, South Africa |
| Cathy Kalombo | Metro-District Health Services, Gugulethu, Cape Town, South Africa |
| Andre-Pascal Kengne | Non-communicable Diseases Research Unit, South African Medical Research Council, Durban and Cape Town, South Africa |
Data Collection
Dates of Data Collection
| Start | End |
|---|---|
| 2014-03-02 | 2020-07-01 |