Geoffrey Setswe

National responses to HIV/AIDS and non-communicable diseases in developing countries: analysis of strategic parallels and differences

HIV/AIDS and non-communicable diseases (NCDs) epidemics may have many important similarities in their aetiology, pathogenesis and management. Evidence about the similarities and differences between the national responses HIV/AIDS and NCDs is essential for an integrated response. The objective of this study was to examine the parallels and differences between national responses to HIV/AIDS and NCDs in selected developing countries. This study applied a strategic level comparative case study approach as its study design. The main construct was national response to HIV/AIDS and NCDs. The 4 overarching themes were policy response, institutional mechanism, programmatic response and strategic information. Four countries were purposively selected as cases. Data were collected and triangulated from a multiple sources. The focus of analysis included identifying items for comparison, characteristics to be compared, degrees of similarity, and strategic importance of similarities. Analysis of data was qualitative content analysis with within-case, between-case, and across-case comparisons. While the nature of the disease and the contents of national HIV/AIDS and NCD policies are different, the policy processes involved are largely similar. Functional characteristics of programmatic response to HIV/AIDS and NCDs are similar. But the internal constituents are different. Though both HIV and NCDs require both a multi-sectorial response and a national coordination mechanism, the model and the complexity of the coordination are different. Strategic information frameworks for HIV/AIDS and NCDs use similar models. However, the indicators, targets and priorities are different. In conclusion, the national responses between HIV/AIDS and NCDs are largely similar in approaches and functions but different in content. Significance for public health This study explores the parallels and differences between national responses to HIV/AIDS and non-communicable diseases (NCDs). The identified parallels can be the basis for integrated response to HIV/AIDS and NCDs. In contrast, the important differences are essential for maintaining the integrity of the responses to HIV/AIDS and NCDs in the process of integration.

Developing an Action Model for Integration of Health System Response to HIV/AIDS and Noncommunicable Diseases (NCDs) in Developing Countries

Introduction: Although there are several models of integrated architecture, we still lack models and theories about the integration process of health system responses to HIV/AIDS and NCDs. Objective: The overall purpose of this study is to design an action model, a systematic approach, for the integration of health system responses to HIV/AIDS and NCDs in developing countries. Methods: An iterative and progressive approach of model development using inductive qualitative evidence synthesis techniques was applied. As evidence about integration is spread across different fields, synthesis of evidence from a broad range of disciplines was conducted. Results: An action model of integration having 5 underlying principles, 4 action fields, and a 9-step action cycle is developed. The INTEGRATE model is an acronym of the 9 steps of the integration process: 1) Interrelate the magnitude and distribution of the problems, 2) Navigate the linkage between the problems, 3) Testify individual level co-occurrence of the problems, 4) Examine the similarities and understand the differences between the response functions, 5) Glance over the health system’s environment for integration, 6) Repackage and share evidence in a useable form, 7) Ascertain the plan for integration, 8) Translate the plan in to action, 9) Evaluate and Monitor the integration. Conclusion: Our model provides a basis for integration of health system responses to HIV/AIDS and NCDs in the context of developing countries. We propose that future empirical work is needed to refine the validity and applicability of the model.

Global responses to HIV/AIDS and noncommunicable diseases: analysis of similarities and differences.

ABSTRACT Introduction: Recent evidence suggests that HIV/AIDS and Noncommunicable diseases(NCDs) share essential commonalities in their risk factors, progression andmanagement. However, the interrelatedness between the global responses to HIV/AIDSand NCDs hasn’t been systematically analyzed.Objective: To examine the similarities and differences between global responses toHIV/AIDS and NCDs.Methods: Using preliminary review of literature, we identified four major themes of theglobal response: Strategies, Systems, Intervention and Monitoring and Evaluation.Detailed review of purposively selected documents was then conducted under these fourthemes. Similarities and differences between the global response to HIV/AIDS andNCDs were then examined for each major theme using qualitative content analysis andinterpretive synthesis. The findings were presented using narrative summaries, tablesand boxes.Findings: HIV/AIDS and NCD strategies are similar in their general approach. However,Research Article

Epidemiological Patterns of HIV/AIDS and Diabetes in Developing Countries: A Cluster Analysis

Introduction:HIV/AIDS and Noncommunicable diseases are the major public health threats of developing countries. Analysis of joint epidemiological patterns of these diseases will help in designing and implementing appropriate interventions to mitigate their impacts. Objectives:The overall aim of this study was to analyze Epidemiological patterns of HIV/AIDS and Diabetes in developing countries. Methods: Country level HIV/AIDS and Diabetes prevalence data at four time points, between 2000 and 2010, for 68 countries i n Sub-Saharan Africa, Southern and South Eastern Asia were transformed and analyzed. Joint geographic and temporal trends were described using numerical and graphic summaries. The level of Covariation between HIV and Diabetes prevalence was measured by Pearson correlation. K -means cluster analysis was conducted after the appropriate number of clusters was determined using scree plot technique. Analysis of variance was used to identify factors that differentiate

Community engagement in the introduction and implementation of the National Health Insurance in South Africa

The South African government released a policy document for the introduction of a National Health Insurance (NHI) system planned to start in 2012. The consultation process for involving the public in the implementation of the NHI was also announced in August. When the consultation process on the NHI was announced, everyone assumed that the Government’s aim was to devolve power to communities and create a more patient-focused and community-oriented NHI. In this paper we look not only at how community engagement process on the NHI works, but we also review the democratic process to determine if it is a good means of holding decision makers to account to communities before and during the implementation of the NHI in South Africa. We review reasons for involving or engaging communities in health and related matters, the policy context of community engagement and review potential roles of non-governmental organizations in assisting people to participate in debates for implementation of this new health policy initiative.