Management of Co-Morbidity of Depression and Chronic Non- Communicable Diseases in Rwanda

Abstract

BACKGROUND: Chronic non-communicable diseases (NCDs) area major global health problem of the 21 stcentury. They are nowthe world’s leading cause of disease burden and high mortality. Aneven more alarming health problem is when depression coexistswith chronic NCDs, as is frequently the case. Management of thisco-morbidity with collaborative care has become a global topic ofinterest, with the World Health Organization (WHO)recommending implementation of collaborative care for thispurpose. The study investigated existing protocols and/orinterventions for managing this co-morbidity in Rwandan districthospitals.METHODS: The study used an action research design involving aresearch team of 14 health care professionals to collaborativelyidentify existing protocols or interventions for managing co-morbidity of depression and NCDs in Rwanda. Focus groupdiscussion using a structured interview guide was used to collectqualitative data, followed by qualitative content analysis usinginductive approach.RESULTS: We found no particular protocols or interventions inplace to manage the co-morbidity of depression and chronic NCDs.Depression and chronic NCDs were found to be treated separately,in separate health care settings and by different healthprofessionals.CONCLUSION:The findings revealed a gap in management of co-morbid depression and chronic NCDs in Rwanda district hospitals.We recommend that health care providers follow the WHOcollaborative care advisory for better quality care and better patientimprovement in management of this co-morbidity.