Pathways to Care for Patients With Type 2 Diabetes and HIV/AIDS Comorbidities in Soweto, South Africa: An Ethnographic Study

Bosire, Edna N; Norris, Shane A.; Goudge, Jane; Mendenhall, Emily

doi:10.9745/ghsp-d-20-00104

Cited by 8 publications

(15 citation statements)

References 50 publications

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“…NCDs such as cancer, diabetes) [2 ▪▪ ,11]. Analytic approaches can include explicit attention to such interactions as detailed in recent qualitative [67], mixed-methods [41 ▪▪ ] and quantitative [45 ▪▪ ] syndemic HIV research studies.…”

Section: Discussionmentioning

confidence: 99%

Context, COVID-19 and comorbidities: exploring emergent directions in syndemics and HIV research

Logie

Coelho

Kohrt

et al. 2022

Current Opinion in HIV and AIDS

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Purpose of reviewThe purpose of this review is to identify themes across articles that aimed to explore HIV-related syndemics in 2020 and 2021 and to discuss their implications for research on syndemics. Recent findingsWe identified 189 articles on syndemics between 2020 and 2021. Key themes across studies included COVID-19; mental health and psychosocial challenges; substance use; socio-structural factors; protective factors; and methodological approaches. COVID-19's implications for HIV syndemic research were discussed. Mental health and substance use research largely examined linkages with sexual practices or reduced HIV care retention. Researchers examined associations between socio-structural variables (e.g. poverty) and elevated HIV exposure, reduced HIV testing and poorer health. Concepts of water insecurity and 'ecosyndemics' were also raised, as was the importance of attending to noncommunicable diseases and comorbidities. Most studies did not assess interactions between health conditions, signalling the need for methodological grounding in the foundational concepts of syndemic theory.

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Section: Discussionmentioning

confidence: 99%

Context, COVID-19 and comorbidities: exploring emergent directions in syndemics and HIV research

Logie

Coelho

Kohrt

et al. 2022

Current Opinion in HIV and AIDS

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“…In South Africa, little collaboration among healthcare providers was reported to address Type 2 Diabetes and HIV/AIDS comorbidities. It was mainly due to poor communication, noncentralized patient information, and staff shortages [ 24 ]. These deficiencies in coordination and the interruption of services foresees a worrying scenario for access to health services.…”

Section: Discussionmentioning

confidence: 99%

Response of Care Services for Patients with HIV/AIDS during a Pandemic: Perspectives of Health Staff in Bolivia

López

Solis-Soto

2022

IJERPH

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The COVID-19 pandemic has caused an unprecedented crisis striking health services, generating risks of setbacks in health care and affecting the most vulnerable populations such as HIV patients. This study aims to explore the impact of the COVID-19 pandemic on the operational management of health services for people living with HIV/AIDS in Cochabamba, Bolivia. We applied a qualitative approach using semi-structured in-depth interviews with ten key health professionals who care for patients with HIV/AIDS in Cochabamba, Bolivia. Interviews were transcribed verbatim and uploaded to Atlas.ti software for analysis. We used an ethnographic approach within the interpretive paradigm to carry out the thematic analysis, considering the “Determinants of health systems resilience framework” of five dimensions developed by the World Health Organization. Even though the provision of services in public care services was not interrupted during the COVID-19 pandemic, health service delivery was severely affected. Digital technology could be used to compensate in urban areas. Regarding the distribution of medications, adaptative strategies to reduce patient complications were implemented. Unfortunately, the complementary tests availability was limited. The COVID-19 pandemic had a significant impact on HIV/AIDS patient care services in Cochabamba, with repercussions for HIV treatment access and virologic suppression.

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“…and governance and frameworks and policies to promote collaboration (Bosire et al, 2021;Dankoly et al, 2021;Mercer et al, 2019). In SSA, diabetes management often appears uncoordinated and fragmented, with health professionals providing siloed care.…”

Section: What Does This Paper Contribute To the Wider Global Community?mentioning

confidence: 99%

“…Collaboration involves responsible and accountable cooperation, coordination and partnership among health professionals, healthcare managers and patients, albeit suboptimal in developing countries (Gill et al, 2009; WHO, 2013). Findings from developing countries, including in sub‐Saharan Africa (SSA), identified insufficient levels of collaboration in diabetes care and need for strong leadership and governance and frameworks and policies to promote collaboration (Bosire et al, 2021; Dankoly et al, 2021; Mercer et al, 2019). In SSA, diabetes management often appears uncoordinated and fragmented, with health professionals providing siloed care.…”

Section: Introductionmentioning

confidence: 99%

Collaborative practice in type 2 diabetes management in a developing country: A qualitative study of perceptions and attitudes of key stakeholders

Desse,

Namara,

Yifter

et al. 2023

Journal of Clinical Nursing

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Aims and objectivesTo explore collaborative practice and perceptions and attitudes of key stakeholders on collaboration in type 2 diabetes management in a tertiary care setting.BackgroundUnderstanding collaborative practice in diabetes care in developing countries helps to design and provide patient‐centred and cost‐effective care.DesignAn exploratory qualitative study.MethodsInterviews were undertaken with 30 patients and 18 health professionals and policymakers. Thematic data analysis was undertaken to explore collaborative practice and examine participant perspectives on collaboration in diabetes management. We compared the findings with D'Amour's Collaboration Framework to determine the level of collaboration.ResultsMost participants reported a lack of collaborative practice in diabetes management, while they appreciated its importance in improving care. Perceptions varied with respect to what constituted collaborative practice. Three themes were identified: (1) perspectives of key stakeholders on current practice of collaboration; (2) impediments to collaborative practice; (3) strategies to improve collaborative practice. Analyses of the themes using D'Amour's Collaboration Framework indicated a low level of collaboration among physicians, nurses, pharmacists and policymakers, which was attributed to workload and time pressures on health professionals, power dynamics and lack of role clarity of all actors in collaborative action. Participants commented on the need to improve collaboration by establishing strong leadership and governance at different healthcare structure levels, which is committed to coordinating collaboration and developing collaborative frameworks and policies that guide collaborative undertaking.ConclusionsPerceived shortcomings of collaboration were attributed to inadequate resources, power dynamics, a lack of strong team functioning and policies. Participants' positive perceptions provide an opportunity to improve collaborative practice through incorporation of collaborative frameworks and policies.Relevance to Clinical PracticeThe findings in this study inform development of tailored and patient‐centred diabetes care in tertiary care settings in sub‐Saharan Africa.Reporting MethodThe study was reported in accordance with the COREQ checklist.Patient or Public ContributionPatients or the public were not involved in the design, analysis or interpretation of the data in this study. However, patients and healthcare providers participated in pilot interviews, which helped refine the interview guides. The summary of the findings of the study was also discussed with patients and healthcare providers, where they provided feedback.

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Pathways to Care for Patients With Type 2 Diabetes and HIV/AIDS Comorbidities in Soweto, South Africa: An Ethnographic Study

Cited by 8 publications

References 50 publications

Context, COVID-19 and comorbidities: exploring emergent directions in syndemics and HIV research

Context, COVID-19 and comorbidities: exploring emergent directions in syndemics and HIV research

Response of Care Services for Patients with HIV/AIDS during a Pandemic: Perspectives of Health Staff in Bolivia

Collaborative practice in type 2 diabetes management in a developing country: A qualitative study of perceptions and attitudes of key stakeholders

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