TY - JOUR
T1 - Diabetes—Tuberculosis Care in Eswatini: A Qualitative Study of Opportunities and Recommendations for Effective Services Integration
AU - Williams, Victor
AU - Vos-Seda, Alinda G.
AU - Haumba, Samson
AU - Mdluli-Dlamini, Lindiwe
AU - Calnan, Marianne
AU - Grobbee, Diederick E.
AU - Otwombe, Kennedy
AU - Klipstein-Grobusch, Kerstin
N1 - Funding Information:
VW is funded by the Global Health PhD Support Programme at the University Medical Center, Utrecht, Netherlands. The funders had no role in the study design, collection, analysis, and interpretation of the data, and writing of the manuscript.
Publisher Copyright:
Copyright © 2023 Williams, Vos-Seda, Haumba, Mdluli-Dlamini, Calnan, Grobbee, Otwombe and Klipstein-Grobusch.
PY - 2023/3/30
Y1 - 2023/3/30
N2 - Objective: This study describes the availability of basic services, equipment, and commodities for integrated DM–TB services, best practices by healthcare workers, and opportunities for better integration of DM–TB care in Eswatini.Methods: A qualitative design was used. Twenty-three healthcare workers participated in a survey and key informant interview.Results: Most respondents indicated DM and TB care are integrated and clients access blood pressure and fasting/random blood glucose assessment. Few respondents indicated they provide visual assessment, hearing assessment, and HbA1c testing. Respondents experienced stockouts of urinalysis strips, antihypertensive drugs, insulin, glucometer strips, and DM drugs in the previous 6 months before the interview. Four main themes emerged from the qualitative interviews—quality and current standards of care, best practices, opportunities, and recommendations to improve integrated services delivery.Conclusion: While DM care is provided for TB patients, the implementation of integrated DM–TB services is suboptimal as the quality and current standards of care vary across health facilities due to different patient-level and health system challenges. Some identified opportunities must be utilized for a successful DM–TB integration.
AB - Objective: This study describes the availability of basic services, equipment, and commodities for integrated DM–TB services, best practices by healthcare workers, and opportunities for better integration of DM–TB care in Eswatini.Methods: A qualitative design was used. Twenty-three healthcare workers participated in a survey and key informant interview.Results: Most respondents indicated DM and TB care are integrated and clients access blood pressure and fasting/random blood glucose assessment. Few respondents indicated they provide visual assessment, hearing assessment, and HbA1c testing. Respondents experienced stockouts of urinalysis strips, antihypertensive drugs, insulin, glucometer strips, and DM drugs in the previous 6 months before the interview. Four main themes emerged from the qualitative interviews—quality and current standards of care, best practices, opportunities, and recommendations to improve integrated services delivery.Conclusion: While DM care is provided for TB patients, the implementation of integrated DM–TB services is suboptimal as the quality and current standards of care vary across health facilities due to different patient-level and health system challenges. Some identified opportunities must be utilized for a successful DM–TB integration.
KW - diabetes mellitus
KW - non-communicable diseases
KW - primary healthcare
KW - services integration
KW - tuberculosis
UR - http://www.scopus.com/inward/record.url?scp=85152634376&partnerID=8YFLogxK
U2 - 10.3389/ijph.2023.1605551
DO - 10.3389/ijph.2023.1605551
M3 - Article
C2 - 37065641
SN - 1661-8564
VL - 68
SP - 1
EP - 10
JO - International Journal of Public Health
JF - International Journal of Public Health
M1 - 1605551
ER -