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Assets for integrating task-sharing strategies for hypertension within HIV clinics: Stakeholder's perspectives using
Juliet Iwelunmor1, Ifeoma Maureen Obionu1, Gabriel Shedul2,3
1Department of Behavioral Science and Health Education, College for Public Health and Social Justice Saint Louis University, St. Louis, MO, United States of America.
Insights
Integrating hypertension care (TASSH) into HIV clinics in Nigeria offers opportunities to extend care and empower healthcare professionals. Key stakeholders identified assets that can strengthen HIV clinics for better hypertension management in people living with HIV.
Area of Science:
- Public Health
- Health Services Research
- Non-communicable Diseases
Background:
- Increased life expectancy for people living with HIV (PLWH) in Nigeria due to antiretroviral therapy.
- Rising rates of non-communicable diseases, particularly cardiovascular diseases, among PLWH.
- Need to address comorbidities like hypertension within existing HIV care frameworks.
Purpose of the Study:
- To explore key stakeholder perspectives on integrating task-sharing strategies for hypertension care (TASSH) into Nigerian HIV clinics.
- To identify facilitators and barriers to implementing TASSH within HIV care settings.
Main Methods:
- Qualitative in-depth interviews with diverse stakeholders (PLWH, advocates, healthcare professionals, policymakers).
- Interviews conducted in Akwa Ibom, Nigeria, focusing on TASSH integration facilitators and barriers.
- Analysis using the PEN-3 cultural model and framework thematic analysis.
Main Results:
- Three key asset themes emerged for TASSH integration: extending continuity of care for PLWH.
- Empowering healthcare professionals within the existing HIV clinic structure.
- Enhancing workflow, staff motivation, and stakeholder advocacy to build capacity for TASSH.
Conclusions:
- Identified assets within Nigerian HIV clinics can be leveraged to enhance TASSH integration for PLWH.
- Findings provide knowledge for stakeholders to improve hypertension care delivery.
- Further research needed to evaluate the impact of these assets on TASSH implementation and patient outcomes.
Background:
Access to antiretroviral therapy has increased life expectancy and survival among people living with HIV (PLWH) in African countries like Nigeria. Unfortunately, non-communicable diseases such as cardiovascular diseases are on the rise as important drivers of morbidity and mortality rates among this group. The aim of this study was to explore the perspectives of key stakeholders in Nigeria on the integration of evidence-based task-sharing strategies for hypertension care (TASSH) within existing HIV clinics in Nigeria.
Methods:
Stakeholders representing PLWH, patient advocates, health care professionals (i.e. community health nurses, physicians and chief medical officers), as well as policymakers, completed in-depth qualitative interviews. Stakeholders were asked to discuss facilitators and barriers likely to influence the integration of TASSH within HIV clinics in Akwa Ibom, Nigeria. The interviews were transcribed, keywords and phrases were coded using the PEN-3 cultural model as a guide. Framework thematic analysis guided by the PEN-3 cultural model was used to identify emergent themes.
Results:
Twenty-four stakeholders participated in the interviews. Analysis of the transcribed data using the PEN-3 cultural model as a guide yielded three emergent themes as assets for the integration of TASSH in existing HIV clinics. The themes identified are: 1) extending continuity of care among PLWH; 2) empowering health care professionals and 3) enhancing existing workflow, staff motivation, and stakeholder advocacy to strengthen the capacity of HIV clinics to integrate TASSH.
Conclusion:
These findings advance the field by providing key stakeholders with knowledge of assets within HIV clinics that can be harnessed to enhance the integration of TASSH for PLWH in Nigeria. Future studies should evaluate the effect of these assets on the implementation of TASSH within HIV clinics as well as their effect on patient-level outcomes over time.
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