ISQUA18-0035Integrating Hypertension Management in Routine HIV Care Services Through Quality Improvement Collaborative in Namibia

Abstract

Introduction: The prevalence of hypertension (HTN) among Namibia's adult population was 36% (WHO, 2014), ranking it among the top 10 countries with the highest burden globally. Scaleup of life-long antiretroviral therapy (ART) has enabled people living with HIV (PLWH) to reach normal lifespans, resulting in the need to integrate care of chronic diseases into routine HIV care. The Quality Improvement (QI) Collaborative designed to improve retention in care, NAMPROPA, also included an aim to accelerate the integration of HTN screening and treatment into HIV clinical service delivery programs. Launched in February 2017, NAMPROPA is led by the Ministry of Health and Social Services (MoHSS) with support through PEPFAR, and has reached >50,000 ART patients across 24 sites in 3 regions. Learning Objective: To demonstrate the effectiveness of accelerated implementation of QI to integrate HTN screening and treatment into HIV care programs in Namibia. Conclusions: Through the NAMPROPA QI collaborative, Namibia demonstrated the feasibility of integrating routine HTN screening and treatment into existing HIV clinical services. Multiple change strategies involving redesign of both care and information systems, provision of resources like digital BP monitors, and the empowerment of nurses to prescribe antihypertensive medications are examples of system-level changes that are critical for sustainability.