NDLI: Factors that shape the integration of HIV and TB services in Zomba District, Malawi

Content Provider	Springer Nature : BioMed Central
Author	Maseko, Alex F. Silumbwe, Adam Maritim, Patricia Munakampe, Margarate N. Chirambo, Griphin Baxter Jacobs, Choolwe Zulu, Joseph M.
Abstract	Background The co-occurrence of HIV and tuberculosis (TB) presents significant challenges for effective healthcare delivery and patient outcomes. Integrating HIV and TB services has been recognised as a key strategy to optimise care and improve health outcomes. However, the factors that shape the optimal integration of these services remain unclear in many settings. This study aimed to explore the factors that influence the integration of HIV and TB services. Methods A purposive sampling technique was used to select study participants from 3 selected health facilities in Zomba, Malawi. This study used an exploratory qualitative case study and was performed from February to March 2024. A total (n = 31) of semistructured interviews were conducted. Healthcare providers (n = 12), program coordinators (n = 4), and recipients of care (n = 15) involved in the delivery of HIV and TB services were purposefully included. Thematic analysis using the Atun framework, which groups factors shaping integration around the problem, intervention, adoption system, health system characteristics and broad context, was employed. Results Increased workload among health workers and side effects among patients were reported barriers given the nature of the problem. The benefits of integrating HIV/TB services and compatibility with one’s job shaped HIV/TB integration. The adoption system-related factors included the role of volunteers and nongovernmental organisations. Health system characteristics facilitating HIV/TB integration included strong positive relationships among stakeholders, the provision of incentives and the availability of demand-generating activities. Structural challenges, a lack of financial support and shortages of commodities and supplies were health system-related barriers. Broad contextual factors facilitating HIV/TB integration included strong political will, whereas barriers included the impact of religious, sociocultural and economic factors, including the impact of natural disasters and the COVID-19 pandemic. Conclusion The effective integration of HIV and TB services is contingent upon addressing systemic and contextual barriers while leveraging facilitating factors. Enhancing health worker capacity, ensuring consistent supply chains, and fostering strong stakeholder relationships are vital steps. Additionally, comprehensive strategies that address these multifaceted issues are key to achieving successful integration and better health outcomes.
Related Links	https://bmchealthservres.biomedcentral.com/counter/pdf/10.1186/s12913-025-12367-8.pdf
Ending Page	14
Page Count	14
Starting Page	1
File Format	HTM / HTML
ISSN	14726963
DOI	10.1186/s12913-025-12367-8
Journal	BMC Health Services Research
Issue Number	1
Volume Number	25
Language	English
Publisher	BioMed Central
Publisher Date	2025-02-06
Access Restriction	Open
Subject Keyword	Public Health Health Administration Health Informatics Nursing Research Integration Barriers Facilitators Recipients of care HIV TB One-stop shop
Content Type	Text
Resource Type	Article
Subject	Health Policy

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

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