Moving forward: scaling-up the integration of an HIV and hypertension program in Akwa Ibom State, Nigeria.

As people living with HIV experience increased life expectancy, there is a growing concern about the burden of comorbid non-communicable diseases, particularly hypertension. This brief describes the current policy landscape on the management of HIV and hypertension in Akwa Ibom State, Nigeria, stakeholder engagement meetings, and the resulting five policy recommendations rooted in an ongoing research study designed to integrate hypertension management into HIV care across primary health centers in the State. In order to identify the current gaps in integrated care, discussion sessions with three stakeholder groups (i.e., healthcare providers, patient advocacy groups, and policy makers) were held separately in November 2022. The discussions were purposed to brainstorm policy-level solutions for integrating hypertension into HIV treatment. After all the sessions were concluded, there were five recommendations provided by the stakeholders for integrating HIV and hypertension care in the Akwa Ibom State. Stakeholders unanimously agreed with the need to integrate hypertension care for HIV impacted communities in the State. Specifically, stakeholders recommended to: (1) engage retired community health nurses as mentors; (2) actively link communities to integrated care in clinics; (3) integrate hypertension management with HIV education; (4) expand health insurance accessibility; and (5) formally integrate hypertension management into primary healthcare centers in Akwa Ibom State.

Moving forward: Scaling-up the integration of an HIV and hypertension program in Akwa Ibom State, Nigeria.

Background: As people living with HIV experience increased life expectancy, there is a growing concern about the burden of comorbid non-communicable diseases, particularly hypertension. This policy brief describes the current policy landscape in Akwa Ibom State, Nigeria, the research activities, and five policy recommendations rooted in an ongoing research study designed to integrate hypertension management into HIV care across primary health centers in the state. Analysis: The policy brief was developed in four steps: review of existing policies, using the reviewed policies to inform research activities, solicitation of stakeholder recommendations via focus group discussions, and formulation of the resulting five policy recommendations for integrating hypertension management into HIV care programs in Akwa Ibom. The key analysis for this brief emerged from the thematic analyses of stakeholder responses. Policy Implications: The five policy recommendations for integrating hypertension management in HIV care in Akwa Ibom State, Nigeria are: 1) build capacity by leveraging retired community nurses as mentors; 2) emphasize community engagement; 3) develop consistent training programs on hypertension management for health workers; 4) expand health insurance accessibility; and 5) formally integrate hypertension management into primary healthcare centers in Akwa Ibom State.