Abstract:
objectives Non-communicable diseases (NCD) are a growing cause of morbidity in low-income
countries including in people living with human immunodeficiency virus (HIV). Integration of NCD
and HIV services can build upon experience with chronic care models from HIV programmes. We
describe models of NCD and HIV integration, challenges and lessons learned.
methods A literature review of published articles on integrated NCD and HIV programs in low-
income countries and key informant interviews were conducted with leaders of identified integrated
NCD and HIV programs. Information was synthesised to identify models of NCD and HIV service
delivery integration.
results Three models of integration were identified as follows: NCD services integrated into centres
originally providing HIV care; HIV care integrated into primary health care (PHC) already offering
NCD services; and simultaneous introduction of integrated HIV and NCD services. Major challenges
identified included NCD supply chain, human resources, referral systems, patient education, stigma,
patient records and monitoring and evaluation. The range of HIV and NCD services varied widely
within and across models.
conclusions Regardless of model of integration, leveraging experience from HIV care models and
adapting existing systems and tools is a feasible method to provide efficient care and treatment for
the growing numbers of patients with NCDs. Operational research should be conducted to further
study how successful models of HIV and NCD integration can be expanded in scope and scaled-up
by managers and policymakers seeking to address all the chronic care needs of their patients
