Performance management in primary healthcare: Nurses’ experiences

The use of the performance management (PM) system is highly contested by public servants in South Africa, although its value as essential to the appraisal and management of staff is undeniable. Before considering the integration of a system or parts of a health system, a diagnosis must be made to assess how segmented it is. The vision of health professionals is essential to obtain a panoramic view of the situation.

The aim of study was to explore nurses’ perceptions and experiences of the PM system at primary healthcare (PHC) facilities in relation to the current health system’s reforms.

Patient-centred care: The patients’ perspective – A mixed-methods pilot study

Patient centredness is a broad concept, a moral philosophy. Patient-centred care can be viewed as the actions of patient-centredness. One of the most pertinent actions that a healthcare practitioner can utilise to deliver patient-centred care is empathic communication. Whilst many medical programmes include empathetic communication skills as part of their curricula, the recipients of this care are not asked about the relevance of this teaching.

Why communities must be at the centre of the Coronavirus disease 2019 response: Lessons from Ebola and human immunodeficiency virus in Africa

As the Coronavirus disease 2019 (COVID-19) pandemic has spread globally, with no effective treatment or vaccine yet available, governments in many countries have put in place social interventions to control the outbreak. Communities are complex and only their members can inform public health experts about their lived realities, the community’s understanding of the outbreak and what will work locally to reduce transmission. 

Approaches to integrating palliative care into African health systems: a qualitative systematic review

Africa is characterized by a high burden of disease and health system deficits, with an overwhelming and increasing demand for palliative care (PC). Yet only one African country is currently considered to have advanced integration of palliative care into medical services and generalized PC is said to be available in only a handful of others. The integration of PC into all levels of a health system has been called for to increase access to PC and to strengthen health systems. Contextually appropriate evidence to guide integration is vital yet limited. This qualitative systematic review analyses interventions to integrate PC into ...

Opportunities and challenges to integrating mental health into HIV programs in a lowand middle-income country: insights from the Nigeria implementation science Alliance

In Nigeria, there is an estimated 1.9 million people living with HIV (PLHIV), 53% of whom utilize HIV care and services. With decreasing HIV-related deaths and increasing new infections, HIV with its associated comorbidities continue to be a key public health challenge in Nigeria. Untreated, comorbid mental disorders are a critical but potentially modifiable determinant of optimal HIV treatment outcomes. This study aimed to identify the challenges and opportunities related to integrating mental health care into existing HIV programs in Nigeria.

Community engagement for successful COVID-19 pandemic response: 10 lessons from Ebola outbreak responses in Africa

During public health emergencies, such as the current COVID-19 Public Health Emergency of International Concern, communities are often poorly involved in the planning and implementation of interventions, yet their commitment is fundamental to control outbreaks. Given the experience of responding to Ebola epidemics in Africa, it is imperative that communities must be accountable to the response to COVID-19. Health actors and authorities must co-construct solutions to address COVID-19 with community leaders and communities. 

Exploring barriers and facilitators to integrated hypertension-HIV management in Ugandan HIV clinics using the Consolidated Framework for Implementation Research (CFIR)

Persons living with HIV receiving antiretroviral therapy have increased risk of cardiovascular disease. Integration of services for hypertension, the primary cardiovascular risk factor, into HIV clinics is recommended in Uganda. The investigator´s prior work was demonstrated multiple gaps in implementation of integrated Hypertension care along the HIV treatment cascade. In this study, they sought to explore barriers to and facilitators of integrating Hypertension screening and treatment into HIV clinics in Eastern Uganda.

Integrating care for non-communicable diseases into routine HIV services: key considerations for policy design in sub-Saharan Africa

There is great interest for integrating care for non-communicable diseases (NCDs) into routine HIV services in sub-Saharan Africa (SSA) due to the steady rise of the number of people who are ageing with HIV. Suggested health system approaches for intervening on these comorbidities have mostly been normative, with little actionable guidance on implementation, and on the practical, economic and ethical considerations of favouring people living with HIV (PLHIV) versus targeting the general population.The authors summarize opportunities and challenges related to leveraging HIV treatment platforms to address NCDs among PLHIV. It is emphasized key considerations that can guide integrated care ...

Context matters: a qualitative study of the practicalities and dilemmas of delivering integrated chronic care within primary and secondary care settings in a rural Malawian district

With the increasing double burden of communicable and non-communicable diseases (NCDs) in sub-Saharan Africa, health systems require new approaches to organise and deliver services for patients requiring long-term care. There is increasing recognition of the need to integrate health services, with evidence supporting integration of HIV and NCD services through the reorganisation of health system inputs, across system levels. This study investigates current practices of delivering and implementing integrated care for chronically-ill patients in rural Malawi, focusing on the primary level.

Human-centered design as a guide to intervention planning for non communicable diseases: the BIGPIC study from Western Kenya

Non-communicable disease (NCD) care in Sub-Saharan Africa is challenging due to barriers including poverty and insufficient health system resources. Local culture and context can impact the success of interventions and should be integrated early in intervention design. Human-centered design (HCD) is a methodology that can be used to engage stakeholders in intervention design and evaluation to tailor-make interventions to meet their specific needs.