A Scoping Review of Operational Research for Integrating Non-Communicable Disease Screening into HIV Clinics in Lilongwe, Malawi

In Lilongwe, Malawi, the concurrent high prevalence of HIV and increasing burden of non-communicable diseases (NCDs) strain the healthcare system. Integrating NCD screening into established HIV clinics is a proposed strategy to enhance service efficiency and comprehensiveness. Operational research is needed to guide effective implementation within this specific context. This scoping review aims to map and synthesise existing operational research on integrating NCD screening into HIV clinics in Lilongwe, Malawi. Its objectives are to identify the key integration models, research methodologies, implementation challenges, and reported outcomes documented in this field. The review was conducted according to the Joanna Briggs Institute methodology. A systematic search was performed across relevant electronic databases and grey literature sources. Included studies focused on operational aspects of integrating screening for hypertension, diabetes, or similar NCDs into HIV service delivery in Lilongwe. Extracted data were charted and analysed thematically. The search identified a limited but focused body of literature. Operational research has primarily comprised feasibility and acceptability studies. A dominant theme was task-shifting, using existing HIV clinic staff, such as lay healthcare workers, to conduct basic NCD screenings like blood pressure measurement. Reported challenges included clinic space constraints, intermittent commodity stock-outs, and increased patient waiting times. Existing operational research in Lilongwe offers preliminary evidence that integrating NCD screening into HIV clinics is feasible. The literature remains nascent and largely descriptive, indicating a significant gap in studies assessing impact on clinical outcomes, cost-effectiveness, and sustainable scale-up. Future operational research should employ comparative designs to evaluate specific integration models. Priorities include assessing long-term sustainability, effects on patient clinical outcomes, and detailed economic evaluations to inform policy. HIV, non-communicable diseases, integration, screening, operational research, Malawi, task-shifting. This review consolidates the current state of operational research on NCD-HIV service integration in Lilongwe, identifying evidence gaps to guide future research and programme planning.