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      Towards reframing health service delivery in Uganda: the Uganda Initiative for Integrated Management of Non-Communicable Diseases

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          Abstract

          Background

          The burden of non-communicable diseases (NCDs) in low- and middle-income countries (LMICs) is accelerating. Given that the capacity of health systems in LMICs is already strained by the weight of communicable diseases, these countries find themselves facing a double burden of disease. NCDs contribute significantly to morbidity and mortality, thereby playing a major role in the cycle of poverty, and impeding development.

          Methods

          Integrated approaches to health service delivery and healthcare worker (HCW) training will be necessary in order to successfully combat the great challenge posed by NCDs.

          Results

          In 2013, we formed the Uganda Initiative for Integrated Management of NCDs (UINCD), a multidisciplinary research collaboration that aims to present a systems approach to integrated management of chronic disease prevention, care, and the training of HCWs.

          Discussion

          Through broad-based stakeholder engagement, catalytic partnerships, and a collective vision, UINCD is working to reframe integrated health service delivery in Uganda.

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          Most cited references19

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          Global action plan for the prevention and control of noncommunicable diseases 2013–2020

          (2013)
          Article 0 comments Cited 135 times – based on 0 reviews     Review now
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            Double burden of noncommunicable and infectious diseases in developing countries.

            I C Bygbjerg (2012)
            On top of the unfinished agenda of infectious diseases in low- and middle-income countries, development, industrialization, urbanization, investment, and aging are drivers of an epidemic of noncommunicable diseases (NCDs). Malnutrition and infection in early life increase the risk of chronic NCDs in later life, and in adult life, combinations of major NCDs and infections, such as diabetes and tuberculosis, can interact adversely. Because intervention against either health problem will affect the other, intervening jointly against noncommunicable and infectious diseases, rather than competing for limited funds, is an important policy consideration requiring new thinking and approaches.
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              Why reinvent the wheel? Leveraging the lessons of HIV scale-up to confront non-communicable diseases.

              Miriam Rabkin, Wafaa El-Sadr (2010)
              The dramatic scale-up of HIV services in lower-income countries has led to the development of service delivery models reflecting the specific characteristics of HIV and its treatment as well as local contexts and cultures. Given the shared barriers and challenges faced by health programmes in lower-income countries, many of the implementation approaches developed for HIV programmes have the potential to contribute to the continuity care framework needed to address non-communicable diseases (NCDs) in resource-limited settings. HIV programmes are, in fact, the first large-scale chronic disease programmes in many countries, offering local and effective tools, models and approaches that can be replicated, adapted and expanded. As such, they might be used to 'jumpstart' the development of initiatives to provide prevention, care and treatment services for NCDs and other chronic conditions.
              Article 0 comments Cited 76 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Glob Health Action
                Journal ID (iso-abbrev): Glob Health Action
                Journal ID (publisher-id): GHA
                Title: Global Health Action
                Publisher: Co-Action Publishing
                ISSN (Print): 1654-9716
                ISSN (Electronic): 1654-9880
                Publication date (Electronic): 05 January 2015
                Publication date Collection: 2015
                Volume: 8
                Electronic Location Identifier: 10.3402/gha.v8.26537
                Affiliations
                [1 ]Uganda Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda
                [2 ]Section of General Internal Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
                [3 ]Global Health Corps, New York, NY, USA
                [4 ]Department of Community Health, Government of Uganda Ministry of Health, Kampala, Uganda
                [5 ]Mulago National Referral Hospital, Kampala, Uganda
                [6 ]Yale Global Health Leadership Institute, New Haven, CT, USA
                [7 ]Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
                Author notes
                [* ]Correspondence to: Jeremy I. Schwartz, Yale School of Medicine, Yale-New Haven Hospital, 1450 Chapel Street, New Haven, CT 06511, USA, Email: Jeremy.schwartz@ 123456yale.edu

                Responsible Editor: Nawi Ng, Umeå University, Sweden.

                Article
                Publisher ID: 26537
                DOI: 10.3402/gha.v8.26537
                PMC ID: 4292588
                PubMed ID: 25563451
                SO-VID: 56648918-bd21-4e72-b369-2d174e0170ac
                Copyright © © 2015 Jeremy I. Schwartz et al.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 03 November 2014
                Date revision received : 01 December 2014
                Date accepted : 02 December 2014
                Categories
                Subject: Capacity Building

                ScienceOpen disciplines: Health & Social care
                Keywords: non-communicable diseases,health system strengthening,integration,multi-sectoral collaboration
                Data availability:
                ScienceOpen disciplines: Health & Social care
                Keywords: non-communicable diseases, health system strengthening, integration, multi-sectoral collaboration

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