Mapping the evidence on integrated service delivery for non-communicable and infectious disease comorbidity in sub-Saharan Africa: protocol for a scoping review.

INTRODUCTION: The concurrent occurrence of infectious diseases (IDs) and non-communicable diseases (NCDs) presents complex healthcare challenges in sub-Saharan Africa (SSA), where healthcare systems often grapple with limited resources. While an integrated care approach has been advocated to address these complex challenges, there is a recognised gap in comprehensive evidence regarding the various models of integrated care, their components and the feasibility of their implementation. This scoping review aims to bridge this gap by examining the breadth and nature of evidence on integrated care models for NCDs and IDs within SSA, thereby updating the current evidence base in the domain. METHODS AND ANALYSIS: Based on the Joanna Briggs Institute (JBI) framework for scoping reviews, this study will include peer-reviewed and grey literature reporting on integrated care models for NCD-ID comorbidities in SSA. A comprehensive search of published sources in electronic databases (PubMed, Scopus, Embase, the Cochrane Library, Health System Evidence and Research4Life) and grey literature (Google Scholar, EBSCO Open Dissertations and relevant organisational websites) will be conducted to identify sources of information reported in English from 2018 onwards. The review will consider sources of evidence reporting on integrated care model for NCDs such as diabetes; chronic cardiovascular, respiratory and kidney diseases; cancers; epilepsy; and mental illness, and comorbid IDs such as HIV, tuberculosis and malaria. All sources of evidence will be considered irrespective of the study designs or methods used. The review will exclude sources that solely focus on the differentiated or patient-centred care delivery approach, and that focus on other conditions, populations or settings. The reviewers will independently screen the sources for eligibility and extract data using a JBI-adapted data tool on the Parsifal review platform. Data will be analysed using descriptive and thematic analyses and results will be presented in tables, figures, diagrams and a narrative summary. ETHICS AND DISSEMINATION: Ethical approval is not required for this review as it will synthesise published data and does not involve human participants. The final report will be submitted for publication in a peer-reviewed journal. The findings will be used to inform future research. STUDY REGISTRATION: OSF: https://doi.org/10.17605/OSF.IO/KFVEY.

Relationships of Nurses with Midwives in Their Working Area and Associated Factors at Jimma Medical Center, Jimma, Southwest Ethiopia.

Background: Good relationships among healthcare professionals in general and nurses and midwives, in particular, are vital in creating a smooth working environment and producing the best services from these two backbones of healthcare. Unfortunately, no studies have been conducted in Ethiopia that assesses the relationship between nurses and midwives in health facilities and the possible associated factors. Thus, this study aimed to assess the relationship between nurses and midwives in their working areas and factors associated with their relationships. Methods: An institution-based cross-sectional study was conducted among 358 nurses at Jimma medical center, Jimma, Southwest Ethiopia. The sample size was calculated using a single-population proportion formula, and a simple random sampling technique was used to select individual study participants. Data were collected using a semistructured self-administered questionnaire prepared in the local language. Data were entered into epi-data version 4.2, and the analysis was conducted using the statistical packages for social sciences version 23. The level of significance was declared at a p-value less than .05 in the final multivariable logistic regression model. The results are presented in a figure, tables, frequencies and percentages, and narratives. Results: This study indicated that 284 (79.60%) nurses had good relationships with midwives in their work area, and the remaining 74 (20.40%) had poor relationships. The rules and regulations of the hospital (p = .009, adjusted odds ratio [AOR] = 0.478, confidence interval [CI]: (0.274, 0.833)) and years of experience (p = .039, AOR = 8.391, CI: (1.120, 9.845)) were found to have statistically significant associations with relationships between nurses and midwives. Conclusion: It could be concluded that there is a relatively good relationship between nurses and midwives at Jimma medical center. Although there is a good relationship, it is vital to make nurses aware of the importance of good relationships. Enabling hospital rules and regulations to be helpful in fostering relationships between nurses and midwives and working with nurses with few years of experience to develop good relationships with midwives is recommended.

Perceived impact of COVID-19 on routine care of patients with chronic non-communicable diseases: a cross-sectional study.

Introduction: patients with chronic non-communicable diseases (chronic liver diseases, chronic respiratory diseases, neurologic diseases, chronic kidney diseases, cardiovascular diseases, diabetes mellitus, and hypertension), primarily poor, rural and neglected populations, have had difficulty accessing health care and have been severely impacted both socially and financially in during the pandemic. As a result, this study was designed to assess the perceived impact of COVID-19 on routine care of chronic non-communicable disease patients in Ethiopia. Methods: a cross-section survey was conducted among 404 participants from April 1st 2021 to May 30th 2021. Data were collected via interviewer administered questionnaires administered by pre-tested interviewers on socio-demographic characteristics, treatment and clinical features and routine care questionnaires that have been adapted and modified from different literatures. The study consisted of all adult outpatients with at least one chronic non-communicable disease who were followed up. Data were analyzed using the Statistical Package for Social Sciences Version 23. Results: of the 422 participants, 404 responded for a response rate of 95.7%. One out of two (203, 50.2%) participants was aged 40 to 50 years. Ninety-one out of hundred (367, 90.8%) participants continued to receive routine care face-to-face during COVID-19. One-third (141, 34.9%) of study participants had good management of the chronic non-communicable diseases care in the middle of pandemic. A total of 167(41.34%) participants thought they were moderately affected changes in healthcare services since the COVID-19 outbreak. Nearly one-third (130, 32.2%) of participants were sometimes affected by medication shortages since the start of COVID-19. Conclusion: this study highlights that most participants continued to receive routine care face-to-face during the COVID-19. About forty-one out of 100 participants perceived that they were moderately affected changes in healthcare services since the outbreak of COVID-19. One-third of participants sometimes perceived that they were affected by medication shortages since the start of COVID-19.