Table 2 Likert Scale scores for ‘Service Provision’ statements in Rounds 1 and 2
| Â | Round 1 | Round 2 | ||||||
|---|---|---|---|---|---|---|---|---|
| Â | Score 1-3 | Score 4-6 | Score 7-9 | Â | 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) |