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Table 2 Likert Scale scores for ‘Service Provision’ statements in Rounds 1 and 2

From: Integrating diabetes, hypertension and HIV care in sub-Saharan Africa: a Delphi consensus study on international best practice

  Round 1 Round 2
  Score 1-3 Score 4-6 Score 7-9   Score 1-3 Score 4-6 Score 7-9
Outcomes n n (%) n (%) n (%) n n (%) n (%) n (%)
Drug procurement systems for NCDs and HIV should be integrated 16 4 (25) 4 (25) 8 (50) 9 1 (11) 1 (11) 7 (78)
Drug procurement systems should be strengthened for NCDs for an integrated care programme 16 0 (0) 0 (0) 16 (100) 9 0 (0) 0 (0) 9 (100)
Patients with a chronic disease should be offered a choice of whether to collect routine medication from facilities or in the community 16 1 (6) 2 (12) 13 (82) 9 0 2 (22) 7 (78)
The same adherence interventions and adherence monitoring as used in HIV care should be applied to all patients with a chronic disease 16 1 (6) 3 (18) 12 (76) 9 1 (11) 1 (11) 7 (78)
There should be availability of equipment and access to relevant blood tests for routine monitoring for all conditions 16 0 (0) 0 (0) 16 (100) 9 0 (0) 0 (0) 9 (100)
Health education should be available for all chronic conditions within an integrated care clinic 16 0 (0) 0 (0) 16 (100) 9 0 (0) 0 (0) 9 (100)
There should be community-based education programs utilizing existing social, cultural and religious networks to proactively address stigma within NCD/HIV care 16 0 (0) 3 (18) 13 (82) 9 0 (0) 0 (0) 9 (100)
Most patients with multi-morbidity should be managed by non-physician health workers 16 6 (37) 4 (26) 6 (37) 9 5 (56) 1 (11) 3 (33)
There should be on-site training of health care workers on HIV and NCDs 16 0 3 (18) 13 (82) 9 0 (0) 0 (0) 9 (100)
An integrated care clinic should only deliver care to patients with multimorbidity 16 14 (88) 0 (0) 2 (12) 9 9 (100) 0 (0) 0 (0)
Task shifting should be an essential element of integrated care for HIV, hypertension and diabetes 16 0 (0) 4 (26) 12 (74) 9 0 (0) 0 (0) 9 (100)
Comprehensive community based NCD/HIV services should be used to propagate lifestyle modifications, adherence and follow up appointments so as to reduce the burden of complications and co-morbidities 16 0 (0) 1 (6) 15 (94) 9 0 (0) 0 (0) 9 (100)
Improved data collection and surveillance of NCDs among PLHIV should be used to inform integrated NCD/HIV programme management 16 0 (0) 0 (0) 16 (100) 9 0 (0) 0 (0) 9 (100)
It is important that referral networks from primary to secondary care are not adversely affected by integrated care delivery in primary care 16 1 (6) 4 (26) 11 (68) 9 0 1 (11) 8 (89)
It is important that problems with drug ordering and delivery do not undermine the capacity of ART sites to provide NCD care 16 0 1 (6) 15 (94) 9 0 (0) 0 (0) 9 (100)
aIntegrated clinics may need to be re-launched to avoid being labelled as HIV clinics 16 NA NA NA 9 2 (22) 1 (11) 6 (67)
aAll health workers should undergo training in the provision of integrated chronic care 16 NA NA NA 9 2 (22) 0 (0) 7 (78)
  1. aAdditional outcome suggested by a respondent in Round 1 and added for Round 2