The challenge of dealing with non-AIDS comorbidities for people living with HIV: Perspectives and experiences of patients and healthcare providers

As the cohort of People Living with HIV (PLHIV) ages, so does the spectrum and burden of non-AIDS define HIV-associated conditions (NARC). PLHIV are likely to need different and increased healthcare services. It requires health systems to adapt to this disease trend and conform to a chronic care model, which respects the distinct needs of the ageing population. In this article, we explore the lived experiences of PLHIV and their healthcare providers in managing the challenges of dealing with NARC in Arba Minch, Southern Ethiopia. This study utilises interpretative substantive methods, encompassing qualitative interviews and Focus Group Discussions. The Normalisation Practice Theory (NPT) guided the semi-structured questions concerning routine screenings and current models of HIV care for ageing individuals. The main structural challenges in providing adequate geriatric care included: (i) the lack of awareness of the risk of NARCs; (ii) the absence of blended care; (iii) an HIV-centred approach exclusive of multidisciplinary care; and (iv) financial constraints. In an era with increasing NARCs, traditional HIV care models must adapt to the emerging challenges of a 'greying' and growing population.

Assessment of quality of care provided to adults with type 2 diabetes mellitus at public hospitals in Gamo Gofa zone, Southern Ethiopia: Facility based Cross‐Sectional study

Purpose

Proactive management of type 2 diabetes is important for restoring beta‐cell function and improving sustained blood glucose control. Evidence on quality of diabetes care in Ethiopia is inadequate.

Method

Facility‐based cross‐sectional study was conducted to assess level of quality of care provided to adult type 2 diabetes patients at three public hospitals in Gamo Gofa Zone, Southern Ethiopia.

Results

A total of 210 adult type 2 diabetes patients were included. The mean age of patients was 44.1 ± 9.94 years. Fifty‐one (24.3%) of patients adhered to prescribed medicines. Sixty‐seven (31.9%) patients could benefit from neuropathy screening and referral. Diabetes‐specific evidence‐based guidelines, operational plan to reduce overweight and obesity were not available. There was no periodic lipid profile, renal function and glycated haemoglobin testing. Sixty‐three (30%) patients achieved fasting blood glucose (FBG) level. Only 41 (19.5%) achieved the recommended target value for composite intermediate outcomes. All three sub‐components of quality care structure, process and outcome (SPO) were below the agreed minimum score and the quality of care provided to adult type 2 diabetes was poor. Only 41 (19.5%) achieved agreed quality indicator targets for type 2 diabetes (fasting blood glucose blood pressure and low‐density lipoprotein cholesterol).

Conclusion

The quality of care provided to adult type 2 diabetes patients was poor particularly in areas such as availability of evidence‐based guidelines, operational plan to reduce obesity, monitoring of lipid profile and glycaemic control. Therefore, developing strategies for addressing structure, process and outcome‐related gaps by involving all stakeholders is critical for improving the quality of care provided to these patients.