A framework for implementing integrated HIV and non-communicable disease care at primary health care facilities in Southern Africa

Comorbidities of HIV/AIDS and non-communicable diseases (NCDs) are increasingly prevalent, affecting up to 30% of individuals living with HIV/AIDS, particularly in Sub-Saharan Africa. Conventional approaches that treat NCDs separately from HIV/AIDS care have been deemed inefficient, highlighting the need for integrated models. This study aims to develop a framework for integrating NCD care into HIV programs at primary healthcare facilities in Southern Africa. As part of a broader study examining the burden, extent and cost of HIV/NCD integration we employed a modified ‘Best fit’ framework synthesis method. Thematic analysis was the primary method of analysis used to inform the framework. The study expanded on existing framework themes related to effective team-working, organizational leadership, patient-centered care, community/patient/ provider partnerships. It introduced seven additional themes: country specific NCD prioritization, multi stakeholder partnerships, healthcare worker mental wellbeing, unified health information systems, with enhanced privacy, establishing costing databases for HIV/NCD integrated care, robust monitoring and evaluation mechanisms, and opportunities for regional coordination. Improving existing frameworks for integrating HIV/NCD care is feasible by leveraging established HIV care platforms. These enhancements can support more efficient holistic healthcare delivery across primary healthcare facilities in Southern Africa.