Background
cancers, Cardiovascular disease, NCDs [HIV vertical care, respiratory diseases, diabetes careWe, Diabetes, der Molen T, deaths, hypertension, diabetes
RESPIRATORY DISEASE, CANCERS, CARDIOVASCULAR DISEASE, DIABETES, HYPERTENSION, DISEASES, DIABETES
The global burden of non-communicable diseases (NCDs) continues to increase, with an estimated 41 million deaths annually, equivalent to 71% of all deaths globally (WHO, 2021). Cardiovascular disease accounts for the majority of NCD-related deaths (estimated 17.9 million per year globally), followed by cancers (9.3 million), respiratory diseases (4.1 million), and diabetes (1.5 million) [In sub-Saharan Africa, HIV remains a leading cause of premature adult mortality, occurring alongside the increasing dual burden of NCDs [HIV vertical care in sub-Saharan Africa has allowed health services to focus resources on one condition and this, combined with differentiated models of care which allow easy access to medicines for PLHIV, has led to good outcomes for PLHIV. Management of diabetes and hypertension among PLHIV however remains a major health system challenge in the region [We report here from Uganda which is experiencing a growing burden of NCDs, especially diabetes and hypertension across all socioeconomic strata (Table 
Uganda Profile1.World Bank (2022). Global income classification issued on July 1, 2022. Available at 2. United Nations (2022). Worldometer. Available at 3. The Uganda Population-Based HIV Impact Assessment (UPHIA) (2016–2017) (2018). Available at 3430•PHIA-Uganda-SS_NEW.v14.pdf (columbia.edu)4. International Diabetes Federation (2021). Diabetes Atlas. Available at 5. Lunyera J, Kirenga B, Stanifer JW, Kasozi S, van der Molen T, Katagira W, et al. (2018) Geographic differences in the prevalence of hypertension in Uganda: Results of a national epidemiological study. PLoS ONE 13(8): e0201001. Available at 10.1371/journal. pone.02010016. World Health Organization (2022). Global Health Workforce Statistics, OECD, supplemented by country data. Available at
Integrated HIV and NCD care was initially piloted by our team in a feasibility single-arm intervention study (2018–2020) in selected facilities in central Uganda (MOCCA study) [
Expected benefits of integrated HIV, hypertension and diabetes careWe report here on the outcomes of a process evaluation (PE) of the INTE-AFRICA trial which aimed to explore the experiences, attitudes and practices of a wide variety of stakeholders during implementation and to develop an understanding of the impact of broader social, structural and contextual factors on the process of service integration.