The integration of communicable and non-communicable disease (CD-NCD) health services in Africa: A scoping review

Amid growing challenges in sustaining health programs in low-and-middle-income countries, and the growing burden of multimorbidity, there have been proposals to consolidate services for communicable and non-communicable diseases through integrated care models. However, there is still limited evidence on the intervention components, barriers, and facilitators of integrated care. This study aimed to review the literature on integrated care models implemented in African health systems over the last two decades, with the goal of informing future development in this area. A scoping review was conducted using the Arksey and O'Malley framework. We searched PubMed, MEDLINE, Cochrane Library, SCOPUS, and PsycINFO databases on June 6, 2025. Only peer-reviewed studies on integrated care models for people with at least one communicable disease and non-communicable disease in one or more African countries were considered. A codebook was developed to extract key information, and each study was coded by two independent reviewers. The Consolidated Framework for Implementation Research 2.0 was used to code the barriers and facilitators of integrated care models. The search yielded 419 publications between 2000 and 2025, of which 26 studies were included in this review. The most common integrated care model was the HIV-Hypertension-Diabetes model. Experimental evidence suggested mostly positive outcomes, such as improved blood pressure control and lower facility costs per patient. Key intervention components included training healthcare workers on integration and improving data collection and information systems. Developing NCD care guidelines was the most common facilitator for enhancing integration. The key barriers included limited staff and a lack of equipment, medicines, and diagnostics. Integrated care models are an increasingly used strategy for expanding access to health services in Africa; however, there are several challenges to their implementation. More intervention support and rigorous, community-engaged evaluations are needed to ensure their viability and sustainability in low-resourced settings.