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Pathways to Take care of Sufferers With Sort 2 Diabetes and HIV/AIDS Comorbidities in Soweto, South Africa: An Ethnographic Examine

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ABSTRACTBackground:South Africa is experiencing colliding epidemics of HIV/AIDS and noncommunicable ailments. In response, the Nationwide Division of Well being has carried out built-in power illness administration aimed toward strengthening main well being care (PHC) amenities to handle power sicknesses. Nevertheless, power care continues to be fragmented. This research explored how the well being system capabilities to look after sufferers with comorbid kind 2 diabetes (T2DM) and HIV/AIDS at a tertiary hospital in Soweto, South Africa.Strategies:We employed ethnographic strategies encompassing medical observations and qualitative interviews with well being care suppliers on the hospital (n=30). Information had been transcribed verbatim and thematically analyzed utilizing QSR NVivo 12 software program.Findings:Well being systemic challenges equivalent to the dearth of treatment, untrained nurses, and a restricted variety of docs at PHC clinics necessitated affected person referrals to a tertiary hospital. On the hospital, sufferers with T2DM had been managed first on the medical outpatient clinic earlier than they had been referred to a specialty clinic. These with comorbidities attended completely different clinics on the hospital partly because of the construction of the tertiary hospital that gives specialised care. As well as, little to no collaboration occurred amongst well being care suppliers as a consequence of poor communication, noncentralized affected person info, and employees scarcity. Consequently, sufferers skilled disjointed care.Conclusion:PHC clinics in Soweto have to be strengthened by coaching nurses to diagnose and handle sufferers with T2DM and likewise by making certain sufficient medical provides. We advocate that the medical outpatient clinic at a tertiary hospital also needs to be strengthened to supply built-in and collaborative care to sufferers with T2DM and different comorbidities. Addressing key systemic challenges equivalent to employees shortages and noncentralized affected person info will create a patient-centered versus disease-specific method to care.
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