The growing burden of NCDs among the ageing persons in Sub-Saharan Africa continues to overwhelm healthcare systems and challenge the attainment of SDG three. Although integrated care models have proven effective in managing NCDs in developed countries, there is a paucity of evidence on the acceptability of integrated care in low-resource settings. This study explored perspectives of multi-stakeholders on implementing community-based integrated care for managing HIV, diabetes, and hypertension in Uganda. This qualitative study purposively selected participants through in-depth interviews with health workers, key informant interviews with policymakers, researchers, and NGO representatives, and focus group discussions with patients and community leaders. The study was conducted in communities served by 8 health facilities in two districts of Uganda’s central region. Data were managed using NVivo 14 and analyzed thematically. The findings reveal that community-based integrated care can improve patient care-seeking experiences, medication adherence, and health outcomes, particularly for elderly patients, by fostering efficient time management, reduced travel costs, clinic navigation, coordinated care, and streamlined follow-ups, while enabling patients with multiple conditions to receive simultaneous and personalized services. However, to make the model more patient-centered, participants advocated for the inclusion of care for other common diseases like cough, flu, ulcers, and malaria, and discreet drug packaging would ensure privacy and confidentiality and reduce community stigma, further enhancing medication adherence and strengthening the patient-doctor relationship. Conclusively, community-based integrated care provides a patient-centered mode of care, enhances care continuity, strengthens medication adherence, and presents a viable strategy for improving chronic disease management.

Authors:
Mathias Akugizibwe, Hong Kong Baptist University, Hong Kong
Wing Shan, Hong Kong Baptist University, Hong Kong
Moreen Namulundu, Medical Research Council and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Uganda
Paul Kitandwe, Medical Research Council and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Uganda
Dorothy Mirembe, Medical Research Council and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Uganda
Ivan Namakoola, Medical Research Council and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Uganda

About the Presenter(s)
Mathias, a PhD fellow and university lecturer, has a strong interest in advancing research in social determinants of health. He is currently studying the capacity of health care systems to implement integrated care for chronic diseases in Uganda.

Connect on Linkedin
https://www.linkedin.com/in/akugizibwe-mathias-8208589b/

See this presentation on the full schedule – Thursday Schedule

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