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Strengthening Health Systems for Chronic Care and NCDs: Leveraging HIV Programs to Support Diabetes Services in Ethiopia Zenebe Melaku, ICAP Ethiopia Ahmed Reja, Ethiopian Diabetes Association Miriam Rabkin, ICAP Columbia University Making the HIV-NCD connection • In many resource-limited countries, HIV scale-up has created the first national chronic disease program. • In these same countries, the burden of other chronic diseases, including NCDs such as diabetes, is high and growing rapidly. • We conducted a rapid proof-of-concept study to explore the feasibility of adapting HIV-specific resources for use in a DM program at Adama Hospital in Ethiopia. • Following a baseline assessment, we adapted key strategies, systems, and tools originally developed for the Adama HIV clinic, and introduced them into the OPD for use with adult DM patients. A follow-up assessment was conducted after six months. Intervention Package: Strategies Systems Tools Introduction of an “essential Appointment and defaulter Appointment books package” of key services, tracking systems supplies, and equipment Use of step-by-step protocols Training, clinical mentorship Charting tools, forms to guide care and supportive supervision and flow sheets systems Emphasis on family-focused Peer educator programs Job aids care Identification of a limited Chart review/quality Patient education number of M&E indicators assessment conducted and materials used by clinic staff • No new or experimental services were introduced • No new clinic was created – DM patients were seen within OPD as before • No additional support was provided for medications, laboratory testing or transportation, and no new staff were engaged for implementation • No changes were made to service delivery or staffing at the HIV clinic Six-month outcomes included: • Marked increase in documented service delivery with no added staff; • Expansion of services to include peer education and point-of-service DM screening for patient family members; • Rapid improvement in standards of care.
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