Patient’s acceptability of comprehensive community-based integrated care services for Hiv and Non-communicable diseases in Dar es salaam

Abstract

v ABSTRACT Background: HIV is a global public health threat, affecting nearly 40 million people worldwide, but the majority are in low and middle income countries. Currently, the incidence of Non Communicable Diseases (NCDs) among people living with HIV is increasing, which complicates efforts in care and management for both commodities within communities. Despite the presence of community integrated care initiatives for the management of such comorbidities, the acceptability of the intervention from patients' perspectives isn’t well explored. Study Objective: The study aimed to explore patients' perspectives on the acceptability of comprehensive community based integrated care services for HIV and NCDs in Dar es Salaam, Tanzania. Materials and Methods: This study employed a qualitative cross-sectional design with a phenomenological approach. Conducted at four community sites in Kinondoni Municipality, the study focused on patients enrolled in the INTE-COMM program with diagnoses of HIV, hypertension, or diabetes. Using purposive sampling, 16 participants were selected. Data were analyzed thematically following Braun and Clarke’s six-step process, with Dedoose software facilitating systematic coding and organization. Results: Positive attitudes toward community integrated care, driven by reduced logistical burdens, enhanced accessibility, and strengthened patient provider relationships was observed. Patients reported high satisfaction with the personalized and supportive care they received, underscored by effective communication, privacy, reduced social stigma experience before and minimal disruption to daily activities. Additionally, the proximity and convenience of service locations fostered a sense of empowerment and self efficacy, allowing patients to actively engage in their healthcare with greater ease and confidence. The consistent medication availability and punctual service delivery contributed significantly to patient adherence and trust in the care model. vi Conclusion: Strong patient acceptance of community--based integrated care for HIV and NCDs in Dar es Salaam, attributed to its accessibility, convenience, and supportive care model. Findings suggest that community--based care models can effectively meet the needs of patients with chronic conditions, particularly in resource--limited settings.