ArticleAfrican journal of primary health care & family medicine2016
Sustainability of the integrated chronic disease management model at primary care clinics in South Africa.
Article in African journal of primary health care & family medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 3 of them syntheses that pooled it.
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Who cites it
33 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Multisectoral interventions for urban health in Africa: a mixed-methods systematic review.Global health action · 2024Pooled it
- Built to last? Barriers and facilitators of healthcare program sustainability: a systematic integrative review.Implementation science : IS · 2023Pooled it
- Built to last? The sustainability of healthcare system improvements, programmes and interventions: a systematic integrative review.BMJ open · 2020Pooled it
- Economic evaluation of telemedicine-based integrated management of atrial fibrillation in rural China: a modeling analysis.NPJ digital medicine · 2026Article
- Transforming sickle cell haemotherapy in Africa: building safe, antigen-matched, available, and sustainable transfusion pathways.Frontiers in medicine · 2026Review
- A qualitative study of the social and structural vulnerabilities of HIV and chronic disease syndemics in low-resource urban health facilities in South Africa.Discover public health · 2026Article
- Implementation strategies for integrating non-communicable disease care into primary healthcare settings in sub-Saharan Africa: A systematic review.PLOS global public health · 2026Article
- Experiences of Older People Living with Human Immunodeficiency Virus Comorbidity Attending Coordinated Healthcare Services.Annals of geriatric medicine and research · 2025Article
- Multimorbidity and health system priorities in Zimbabwe: A participatory ethnographic study.PLOS global public health · 2025Article
- Intensity of care and the health status of caregivers to elderly rural South Africans.medRxiv : the preprint server for health sciences · 2024Article
- Determinants of sub-optimal glycemic control among patients enrolled in a medicine dispensing programme in KwaZulu-Natal: A cohort study, 2018-2021.African journal of primary health care & family medicine · 2024Article
- The fall-And rise-In hospital-based care for people with HIV in South Africa: 2004-2017.PLOS global public health · 2024Article
- Sustainability of integrated hypertension and diabetes with HIV care for people living with HIV at primary health care in South Ethiopia: implication for integration.BMC primary care · 2023Article
- Identifying existing approaches used to evaluate the sustainability of evidence-based interventions in healthcare: an integrative review.Systematic reviews · 2022Review
- Multimorbidity patterns and function among adults in low- and middle-income countries: a scoping review protocol.Systematic reviews · 2022Article
- The comorbidity of HIV, hypertension and diabetes: a qualitative study exploring the challenges faced by healthcare providers and patients in selected urban and rural health facilities where the ICDM model is implemented in South Africa.BMC health services research · 2021Article
- Pathways to Care for Patients With Type 2 Diabetes and HIV/AIDS Comorbidities in Soweto, South Africa: An Ethnographic Study.Global health, science and practice · 2021Article
- Article
- Influence of participation in a quality improvement collaborative on staff perceptions of organizational sustainability.BMC health services research · 2021Article
- Performance of quality improvement teams and associated factors in selected regional referral hospitals in Tanzania: a cross-sectional study.The Pan African medical journal · 2021Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
backgroundAn integrated chronic disease management (ICDM) model consisting of four components (facility reorganisation, clinical supportive management, assisted self-supportive management and strengthening of support systems and structures outside the facility) has been implemented across 42 primary health care clinics in South Africa with a view to improve the operational efficiency and patient clinical outcomes.
aimThe aim of this study was to assess the sustainability of the facility reorganisation and clinical support components 18 months after the initiation.
settingThe study was conducted at 37 of the initiating clinics across three districts in three provinces of South Africa.
methodsThe National Health Service (NHS) Institute for Innovation and Improvement Sustainability Model (SM) self-assessment tool was used to assess sustainability.
resultsBushbuckridge had the highest mean sustainability score of 71.79 (95% CI: 63.70-79.89) followed by West Rand Health District (70.25 (95% CI: 63.96-76.53)) and Dr Kenneth Kaunda District (66.50 (95% CI: 55.17-77.83)). Four facilities (11%) had an overall sustainability score of less than 55.
conclusionThe less than optimal involvement of clinical leadership (doctors), negative staff behaviour towards the ICDM, adaptability or flexibility of the model to adapt to external factors and infrastructure limitation have the potential to negatively affect the sustainability and scale-up of the model.
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