Discussion
hypertension, HIV, diabetes, chronic disease
OTHER CHRONIC CONDITION, HYPERTENSION, CHRONIC DISEASE
By interpretation of multi-stakeholder navigation of integrated care, the PE supports greater in-depth multilevel understanding of integrated care in Uganda and helps avoid the Generally, the PE demonstrated multi-stakeholder approval of integrated care for HIV, diabetes and hypertension in the Uganda setting due to the broad range of patient, healthcare provider, health system and community level benefits incurred. Despite resource constraints impacting on drug supply, key findings centre on several areas; high retention rates, acceptability and avoidance of duplication of care processes for people with multiple conditions; increased capacity for screening, diagnosis and treatment of previously undiagnosed comorbid conditions; broadening of skills of health workers to manage multiple conditions; reduction of HIV related stigma, development of peer level sharing of health information, informal groups (‘medicines clubs’) sharing health related information and purchasing of NCD drugs during clinic stockouts.Challenges to multi-morbid chronic disease care centre on linkage and retention in care, access to medicines and adherence to treatment [We speculate that the observed initial experiences of HIV related stigma attached to the clinic may have influenced patient experiences and journeys along the integrated care continuum. The process was dynamic over time, most notably with regard to the minimisation of HIV related stigma. Initial healthcare providers’ misgivings about risk of disrupting HIV care were overcome, leading to staff motivation to continue providing integrated care to their patients. It is encouraging to see that over time this HIV related stigma reduced, along with patient commitment to receiving treatment in a holistic, trusted and confidential environment. Managing HIV alongside any other chronic condition offers substantial opportunity to reduce stigma and can increase effective control of viral loads [Finally, and perhaps most importantly, the PE revealed insights into indirect or unexpected consequences of integrated care, in terms of the developed 