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Journal of Tropical Medicine
Volume 2012, Article ID 137460, 6 pages
Research Article

Strengthening Health Systems for Chronic Care: Leveraging HIV Programs to Support Diabetes Services in Ethiopia and Swaziland

1ICAP Columbia, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY 10032, USA
2Centers for International Programs/ICAP Ethiopia, P.O. Box 5566, Addis Ababa, Ethiopia
3Pact, 1828 L Street NW, Suite 300, Washington, DC 20036, USA
4Ethiopian Diabetes Association, P.O. Box 3184, Addis Ababa, Ethiopia
5ICAP Lesotho, P.O. Box 13860, Maseru, Lesotho
6ICAP Swaziland, P.O. Box 222 Eveni, Mbabane, Swaziland
7Swaziland Ministry of Health, P.O. Box 5, Mbabane, Swaziland

Received 15 March 2012; Accepted 13 August 2012

Academic Editor: Jeffrey V. Lazarus

Copyright © 2012 Miriam Rabkin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The scale-up of HIV services in sub-Saharan Africa has catalyzed the development of highly effective chronic care systems. The strategies, systems, and tools developed to support life-long HIV care and treatment are locally owned contextually appropriate resources, many of which could be adapted to support continuity care for noncommunicable chronic diseases (NCD), such as diabetes mellitus (DM). We conducted two proof-of-concept studies to further the understanding of the status of NCD programs and the feasibility and effectiveness of adapting HIV program-related tools and systems for patients with DM. In Swaziland, a rapid assessment illustrated gaps in the approaches used to support DM services at 15 health facilities, despite the existence of chronic care systems at HIV clinics in the same hospitals, health centers, and clinics. In Ethiopia, a pilot study found similar gaps in DM services at baseline and illustrated the potential to rapidly improve the quality of care and treatment for DM by adapting HIV-specific policies, systems, and tools.