Tuberculosis (TB)

One Stop Shop: Improved individual and population health outcomes through integrated tuberculosis and HIV service delivery in Eswatini

Tuberculosis is the leading cause of morbidity and mortality among people living with HIV; yet uncoordinated clinical care imposes heavy burdens on co-infected patients. In Eswatini, task shifting and the decentralization of TB and HIV treatment services to primary health centers allowed for TB/HIV integrated service delivery, or a ‘one stop shop’. These health system changes resulted in a 28 percent increase in ART initiation of co-infected patients between 2012 and 2017 and in a cohort study, almost 90 percent of TB and HIV co-infected individuals initiated ART within eight weeks per national guidelines. Overall, since implementation began, both morbidity and mortality related to TB have decreased significantly.