“You come at 8 am, by 9 am you go back home to do your work”: Multi-stakeholders' perspectives and experiences of community-based Integrated care management of HIV, diabetes, and hypertension in Uganda

Background The growing burden of multiple chronic conditions, specifically HIV, hypertension, and diabetes, in Sub-Saharan Africa, including Uganda, continues to overwhelm healthcare systems and hinder achieving Sustainable Development Goal 3 on ensuring healthy lives and well-being for all. Although community-based integrated care models have proven effective in high-resource settings, evidence from low-resource contexts remains scarce. This study investigated the experiences and perspectives of multi-stakeholders on the implementation of a community-based integrated care approach for managing these chronic conditions in Uganda. Methods Using a longitudinal design, while employing qualitative techniques and engaging purposively selected participants through in-depth interviews, focus group discussions, and direct observations. Participants included patients, healthcare providers, policymakers, researchers, community leaders, and representatives from NGOs and international organizations. Data were managed using NVivo 14 and analyzed thematically. Results The findings highlight that community-based integrated care significantly improved patient experiences and health outcomes. Patients benefited from interactive health education, simplified clinic navigation, and personalized services such as in-person consultations and counseling. Discreet drug packaging enhanced privacy, confidentiality, and reduced stigma. The model fostered efficient time management, effective communication, coordinated care, and streamlined follow-ups, enabling patients with coexisting conditions to receive simultaneous care in the same setting. These elements contributed to improved medication adherence, better self-efficacy among patients, and strengthened relationships between patients and healthcare providers. Patients also reported lower healthcare access costs and appreciated the convenience, particularly for elderly patients, due to reduced travel and waiting times. Additionally, the waiting environment encouraged peer-to-peer psychosocial support, further enhancing patient well-being. Despite the model’s success in offering patient-centered care and being perceived as more effective than facility-based services, many participants, especially patients, advocated for the inclusion of care for other common communicable diseases like cough, flu, ulcers, and malaria. Conclusion The study concludes that community-based integrated care presents a viable strategy for improving chronic disease management in low-resource settings. It enhances care continuity, strengthens medication adherence, and may be a solution to reduce patient loss to follow-up, all while contributing to improved health outcomes and overall healthcare efficiency in resource-constrained environments.