Background: The unprecedented epidemiologic transition and double burden of disease due to chronic infectious and chronic non-communicable diseases (NCDs) worldwide require health systems to rethink their healthcare delivery mechanisms. This will mandate healthcare workers (HCWs) adopting and adapting to new integrated disease management approaches. Objectives: The study aimed to determine healthcare worker knowledge, attitudes, capacity and skills required for screening and management of chronic NCDs among HIV patients, in order to identify existing gaps on their clinical practice which could affect provision of integrated HIV/ NCDs care in Botswana. Methods: This study employed mixed quantitative and qualitative approaches. This paper reports on the quantitative study, which was a descriptive cross-sectional survey of nurses and doctors caring for HIV patients at randomly selected government facilities in Gaborone, Botswana. Results: Of the 100 questionnaires analysed, only 6% healthcare workers could fully define NCD. HCWs demonstrated good general awareness of diabetes (98%), hypertension (98%), cancer (96%) and cardiovascular diseases (86%) but inadequate in-depth knowledge on all these four Most (88%) believed that integrating HIV/ NCD care would be good use of resources and welcomed it while 62% did not believe that HIV patients with NCDs should be managed at different clinics (figure 1) In practice, over 60% of the HCWs already screened HIV patients for common NCD risk factors including smoking (87.2%), alcohol consumption (90.8%), diet (84.9%), and physical activity (73.5%). NCDs. Surprisingly HIV (11.8%) and malaria (58%) were classified as NCDs (table 1) Conclusion: There was a gap in detailed knowledge on NCDs among surveyed HCWs in Botswana, but a positive attitude towards integrated HIV/NCD management. HCWs already routinely screen HIV patients for NCD risk factors.but only for purposes of HIV risk management. Integrated HIV/NCD care is likely to be positively implemented by healthcare workers if they are provided with relevant training and support.
Dr Masupe is a senior lecturer & assistant program director for the Master of medicine (MMed) Public Health at the University of Botswana (UB). Dr Masupe’s qualifications include a Bachelor of Medicine & Bachelor of Surgery (MBBCh) from Cardiff UK, Master’s in Public Health from South Africa, Master of Science in Occupational Medicine from Manchester UK and currently a PhD fellow in NCDs focusing on type 2 diabetes and hypertension, at the University of the Western Cape, South Africa. She is a fellow alumni of the AFYABORA Global Health Leadership fellowship. She is the first recipient of the Neil Nathanson AfyaBora Global Health leadership award. She has previously worked as a medical doctor and an occupational health physician in UK. Other leadership roles which came about in her capacity as a medical educator include Chair of the national technical working group for Quality And Safety Of Care; Country lead for the May Measurement Month Hypertension project in collaboration with the International Society for Hypertension. She is a fellow of the International Society of Hypertension, Member of the ISH committee for research and education.
Share this page on your timeline