Background:
Many
patients on antiretroviral
therapy (
ART) in
Malawi have or
will develop
non-communicable diseases(NCDs). The current capacity of
ART sites to provide care for NCDs is not known.
Aim:
This study aimed to assess the capacity of
ART sites to provide care for
hypertension and diabetes in rural
Malawi.
Setting:
Twenty-five
health centres and five
hospitals in two rural districts in northern
Malawi.
Methods:
A
cross-sectional survey was performed between March and May 2014 at all facilities. Qualitative interviews were held with three NCD coordinators.
Results:
Treatment of
hypertension and diabetes was predominantly
hospital-based. Sixty percent of
hospitals had at least one clinician and one
nurse trained in NCD care, whereas 5% of
health centres had a clinician and 8% had a
nurse trained in NCD care. Hundred percent of
hospitals and 92% of
health centres had uninterrupted
supply of
hydrochlorothiazide in the previous 6 months, but only 40% of
hospitals and no
health centres had uninterrupted
supply of
metformin. Hundred percent of
hospitals and 80% of
health centres had at least one
blood pressure machine, and 80% of
hospitals and 32% of
health centres had one glucometer.
Screening for
hypertension amongst
ART patients was only conducted at one
hospital and no
health centres. At
health centres, integrated NCD and
ART care was more common, with 48% (12/25) providing
ART and NCD
treatment in the same
consultation.
Conclusions:
The results reflect the status of the initial stages of the
Malawi NCD programme at sites currently providing
ART care