“There is a pressing need to expand the coverage, quality, and equity of services for diabetes mellitus and other noncommunicable diseases in sub-Saharan Africa. Although often overlooked in this context, HIV programs are the first large-scale chronic disease initiatives in the region and, as such, an important resource for those hoping to expand NCD prevention, care, and treatment. In country after country, Ministries of Health — with support from donors and partners — have developed locally owned, contextually appropriate chronic care programs for HIV […] Our hypothesis is that the systems, tools, and implementation strategies developed to provide continuity care for HIV in sub-Saharan Africa can be rapidly, efficiently, and effectively utilized to support services for diabetes and other chronic NCDs.”
The scale-up of HIV services in sub-Saharan Africa has catalyzed the development of highly effective chronic care systems. The strategies, systems, and tools developed to support life-long HIV care and treatment are locally owned contextually appropriate resources, many of which could be adapted to support continuity care for noncommunicable chronic diseases (NCD), such as diabetes mellitus (DM). We conducted two proof-of-concept studies to further the understanding of the status of NCD programs and the feasibility and effectiveness of adapting HIV program-related tools and systems for patients with DM. In Swaziland, a rapid assessment illustrated gaps in the approaches used to support DM services at 15 health facilities, despite the existence of chronic care systems at HIV clinics in the same hospitals, health centers, and clinics. In Ethiopia, a pilot study found similar gaps in DM services at baseline and illustrated the potential to rapidly improve the quality of care and treatment for DM by adapting HIV-specific policies, systems, and tools.