%0 Journal Article
%T Management of Chronic Diseases in Sub-Saharan Africa: Cross-Fertilisation between HIV/AIDS and Diabetes Care
%A Josefien van Olmen
%A Fran£¿ois Schellevis
%A Wim Van Damme
%A Guy Kegels
%A Freya Rasschaert
%J Journal of Tropical Medicine
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/349312
%X There is growing attention for chronic diseases in sub-Saharan Africa (SSA) and for bridges between the management of HIV/AIDS and other (noncommunicable) chronic diseases. This becomes more urgent with increasing numbers of people living with both HIV/AIDS and other chronic conditions. This paper discusses the commonalities between chronic diseases by reviewing models of care, focusing on the two most dominant ones, diabetes mellitus type 2 (DM2) and HIV/AIDS. We argue that in order to cope with care for HIV patients and diabetes patients, health systems in SSA need to adopt new strategies taking into account essential elements of chronic disease care. We developed a ¡°chronic dimension framework,¡± which analyses the ¡°disease dimension,¡± the ¡°health provider dimension,¡± the patient or ¡°person dimension,¡± and the ¡°environment dimension¡± of chronic diseases. Applying this framework to HIV/AIDS and DM2 shows that it is useful to think about management of both in tandem, comparing care delivery platforms and self-management strategies. A literature review on care delivery models for diabetes and HIV/AIDS in SSA revealed potential elements for cross-fertilisation: rapid scale-up approaches through the public health approach by simplification and decentralisation; community involvement, peer support, and self-management strategies; and strengthening health services. 1. Introduction There is growing attention for chronic life-long conditions (CLLCs) in sub-Saharan Africa (SSA) and for the challenge that these countries face in coping with rising numbers of patients with such diseases. The strong advocacy for managing noncommunicable diseases (NCD) appropriately, many of which are life-long, and the more general focus on health systems strengthening has catalysed attention for chronic care [1, 2]. This trend provides an opportunity to move away from the traditional divide between infectious and noninfectious diseases towards new frameworks for managing disease in a broader perspective [3, 4]. HIV/AIDS is the most eye-catching new chronic disease since antiretroviral treatment (ART) became available at large-scale. Despite this recognition, the models of care and approach for HIV/AIDS and other infectious diseases and for chronic NCD have historically grown separately and bringing these together is no easy task. Health systems in SSA have developed with their major objective being the control of acute infections and improving maternal and child health. The rise of HIV/AIDS brought about a major change, because for the first time a chronic health problem received
%U http://www.hindawi.com/journals/jtm/2012/349312/