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1
Outcomes of Universal Access to Antiretroviral Therapy (ART) in Georgia
T. Tsertsvadze; N. Chkhartishvili; L. Sharvadze; et al.
Hindawi Publishing Corporation AIDS Research and Treatment
(2011)
C2
Research Article
Hindawi Publishing Corporation
AIDS Research and Treatment
Volume 2011, Article ID 621078, 7 pages doi:10.1155/2011/621078
This publication provides guidance to governments, civil society organizations (nongovernmental organizations and community-based organizations) and
...
other partners implementing HIV prevention, care and treatment programs with key populations. This guide is designed to assist these programs in the development of monitoring systems for frontline workers (such as peer outreach workers, staff outreach supervisors and program managers) to understand performance. It includes comprehensive tools and forms that various levels of staff can use to collect and analyze data to manage and improve a program.
more
Continuum of HIV services refers to a comprehensive package of HIV prevention, diagnostic, treatment
...
, care and support services provided for people at risk of infection or living with HIV and their families. This revised edition of the guidelines for use of ARV and opportunistic infection
(OI) drugs in adults, adolescents and children is based on recent national and
global evidences and experiences. The Federal Ministry of Health believes that
these guidelines, along with other national guidelines and training manuals, will be
instrumental in maintaining the standard of care and ensuring quality of HIV service
delivery.
more
Biennial Report. SUBMITTED TO THE UNITED NATIONS GENERAL ASSEMBLY SPECIAL SESSION ON HIV AND AIDS
Reporting period: January 2012 – December 2013
...
more
The Zambia Population Based HIV impact assessment of 2016, reported the prevalence of viral hepatitis in Zambia as ranging between 5.6% among adults aged 15 to 59% in the general population,
...
and 7.1% among HIV infected individuals. It is estimated that the majority of persons with chronic hepatitis B and/ or hepatitis C are unware of their infection and do not benefit from promotive, preventive and curative services designed to reduce onward transmission. Zambia introduced hepatitis B virus vaccine to the routine Under 5 vaccination schedule in 2005. Preliminary results from the ZAMPHIA indicate that hundreds of infections have been abated in children since then. However, its also clear that we continue to miss key opportunities to prevent transmission, diagnose and treat infections, prevent serious disease, and in many cases cure people. In addition, high risk groups inter alia health care workers still have limited access to the vaccine.
more
Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the
leading cause of premature mortality in low and middle income countries (LMICs).
Identifying
...
and managing individuals at high risk of CVD is an important strategy to prevent and control CVD, in addition to multisectoral population-based interventions to reduce CVD risk factors in the entire population.
Methods: We describe key public health considerations in identifying and managing individuals at high risk of CVD in LMICs.
Results: A main objective of any strategy to identify individuals at high CVD risk is to maximize the number of CVD events averted while minimizing the numbers of
individuals needing treatment. Scores estimating the total risk of CVD (e.g. ten-year risk of fatal and non-fatal CVD) are available for LMICs, and are based on the main CVD risk factors (history of CVD, age, sex, tobacco use, blood pressure, blood cholesterol and diabetes status). Opportunistic screening of CVD risk factors enables identification of persons with high CVD risk, but this strategy can be widely applied in low resource settings only if cost effective interventions are used (e.g. the WHO Package of Essential NCD interventions for primary health care in low resource settings package) and if treatment (generally for years) can be sustained, including continued availability ofaffordable medications and funding mechanisms that allow people to purchase medications without impoverishing them (e.g. universal access to health care). Thisalso emphasises the need to re-orient health systems in LMICs towards chronic diseases management.
Conclusion: The large burden of CVD in LMICs and the fact that persons with high
CVD can be identified and managed along cost-effective interventions mean that
health systems need to be structured in a way that encourages patient registration, opportunistic screening of CVD risk factors, efficient procedures for the management of chronic conditions (e.g. task sharing) and provision of affordable treatment for those with high CVD risk. The focus needs to be in primary care because that is where most of the population can access health care and because CVD programmes can be run effectively at this level.
more
he UNFPA “Programmatic guidelines: Cash and Voucher Assistance in Sexual and Reproductive Health programming in Emergencies” explains how CVA can be effectively integrated into humanitarian resp
...
onses to help women, girls, and other vulnerable groups access lifesaving and comprehensive SRH services. Rooted in UNFPA’s mandate, this document provides practical direction for designing, implementing, and monitoring CVA within SRH programming.
The guidance highlights the barriers that hinder access to SRH care, such as affordability, availability, acceptability, and appropriateness, and illustrates how CVA can address financial obstacles by covering transport, user fees, or other indirect costs, while reinforcing health system strengthening efforts. CVA is presented as a complementary tool that supports both emergency and long-term SRH goals. Within humanitarian emergencies, it can contribute directly to achieving MISP objectives, including:
Enabling survivors of sexual violence to access clinical and psychosocial care;
Supporting the continuation of HIV and STI treatment, including coverage of transport;
Facilitating safe deliveries and emergency obstetric and newborn care; and
Removing financial barriers to voluntary family planning and contraceptive access, while ensuring informed choice and avoiding coercion.
Beyond the MISP, CVA also supports the transition to comprehensive SRH services in protracted emergencies and recovery phases. Examples include using cash or vouchers to encourage antenatal and postnatal care, ensure menstrual hygiene, sustain cancer prevention and treatment, fund obstetric fistula repair, and promote SRH education among adolescents.
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Background
Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We condu
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cted a randomised controlled trial of an enhanced asthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.
Methods
We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified.
Results
Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach.
Discussion
Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.
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Access to NCD medicines: emergent issues during the COVID-19 pandemic and key structural factors
recommended
The coronavirus disease (COVID-19) pandemic exacerbated pre-existing inequalities in the treatment and care of noncommunicable diseases (NCDs). Thi
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s report examines the effect of the COVID-19 pandemic on access to NCD medicines, and the policies and strategies implemented by countries and health systems to anticipate and mitigate stresses across NCD medicine supply chains. The full range of upstream and downstream impacts are investigated, including: manufacturing; procurement, importation and last mile delivery; patient-level effects through affordability and availability; and the effects on NCD medicine availability by category of disease. The report culminates in recommended actions and interventions for key stakeholders in the NCD pharmaceutical supply chain, including governments, regulatory authorities, manufacturers and the private sector; as well as directions for future research for improving access and supply chain access resilience.
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The coronavirus disease (COVID-19) pandemic exacerbated pre-existing inequalities in the treatment and care of noncommunicable diseases (NCDs). Thi
...
s report examines the effect of the COVID-19 pandemic on access to NCD medicines, and the policies and strategies implemented by countries and health systems to anticipate and mitigate stresses across NCD medicine supply chains. The full range of upstream and downstream impacts are investigated, including: manufacturing; procurement, importation and last mile delivery; patient-level effects through affordability and availability; and the effects on NCD medicine availability by category of disease. The report culminates in recommended actions and interventions for key stakeholders in the NCD pharmaceutical supply chain, including governments, regulatory authorities, manufacturers and the private sector; as well as directions for future research for improving access and supply chain access resilience.
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Guidelines for the prevention, care and treatment of persons with chronic hepatitis B infection
recommended
The recommendations in these guidelines promote the use of simple, non-invasive diagnostic tests to assess the stage of liver disease and eligibility for
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treatment; prioritize treatment for those with most advanced liver disease and at greatest risk of mortality; and recommend the preferred use of nucleos(t)ide analogues with a high barrier to drug resistance (tenofovir and entecavir, and entecavir in children aged 2–11 years) for first- and second-line treatment. Recommendations for the treatment of HBV/HIV-coinfected persons are based on the WHO 2013 Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection, which will be updated in 2015.
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The standards of care for HIV define the expected or desired quality of prevention, treatment, and
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care for people at risk of HIV acquisition or living with HIV.
The standards are based on a scientific rationale, as well as the responsibilities of each stakeholder, to ensure that people receive appropriate, high-quality prevention and care that aligns with the most up-to-date medical knowledge and ethical standards
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Global update on HIV treatment 2013: Results, impact and opportunities
World Health Organization; UNICEF; UNAIDS
(2013)
Chapter 1 provides new data on the latest developments in the global treatment effort, highlighting positive trends as well as aspects that require improvement. Chapter 2 summarizes the impact of the scale-up in reducing AIDS-related mortality
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and new HIV infections. Chapter 3 examines the sequence of steps in the continuum of care from HIV diagnosis to successful provision of ART services and outlines key supportive innovations. Chapter 4 discusses the implications and anticipated impact of the new "Consolidated guidelines on the use of ARV drugs for treating and preventing HIV infection
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The WHO standard: Universal access to rapid tuberculosis diagnostics sets benchmarks to achieve
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universal access to WHO-recommended rapid diagnostics (WRDs), increase bacteriologically confirmed tuberculosis and drug resistance detection, and reduce the time to diagnosis. WHO-recommended rapid diagnostics are highly accurate, cost-effective, reduce the time to treatment initiation, and impact patient-important outcomes.
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3 June 2021. After 40 years of AIDS, charting a course to end the pandemic.
The report shows that countries with progressive laws and policies and
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strong and inclusive health systems have had the best outcomes against HIV. In those countries, people living with and affected by HIV are more likely to have access to effective HIV services, including HIV testing, pre-exposure prophylaxis (medicine to prevent HIV), harm reduction, multimonth supplies of HIV treatment and consistent, quality follow-up and care.
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EMTCT Plus - Framework for Elimination of Mother-to-Child Transmission of HIV, Syphilis, Hepatitis B, and Chagas
F. Pérez; M. B. Mello; L. Sereno;
Pan American Health Organization; World Health Organization
(2017)
C_WHO
The objective of the EMTCT Plus initiative is to achieve and sustain the elimination
of mother-to-child transmission of
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HIV, syphilis, Chagas, and perinatal hepatitis
B (HBV) as a public health threat. It embraces the principles and lines of action
of the Strategy for Universal Access to Health and Universal Health Coverage
[2], building upon the lessons learned from the PAHO 2010 Strategy and Plan of
Action for the EMTCT of HIV and Congenital Syphilis.
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Essential triple EMTCT services include testing for HIV, syphilis and HBV in ante-
natal care (ANC) settings; prompt
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and efficacious interventions to treat women
who test positive; prevent transmission of any of the infections to their children;
counseling for women and their partners to reduce transmission risk and ensure
appropriate treatment; encourage clean and safe delivery; appropriate follow
up of exposed infants including provision of HBV vaccine birth dose; promoting
optimal infant-feeding; and lifelong treatment and care for mothers living with
HIV or those eligible for treatment for hepatitis B infections and treatment for
syphilis.
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Bonchial asthma is the most common chronic respiratory disease in the world. In Kenya, it has been estimated that about 7.5% of the Kenyan population, nearly 4 million people, are currently living with asthma. Many cases tend to be underdiagnosed
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and undertreated which leads to high levels of morbidity and avoidable deaths. The consequences of poorly controlled asthma, including physical, mental, social, and economic impacts, are magnified in the poor on account of poor access to asthma services and sub-optimal quality of those services. With these guidelines, Kenya's Ministry of Health aims to work towards embedding asthma care in Universal Health Care (UHC) to ensure that quality asthma services are available in primary care settings with
referral networks strengthened for those who may require secondary and tertiary care. These national asthma guidelines will also ensure that treatment for asthma is standardized in both the public and the non-state health care sector.
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This policy brief presents a summary of current evidence on vulnerability to TB and proposes interventions for equitable, person-centred, and human
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rights-based TB prevention and care. It aligns with WHO policies and guidance on TB prevention and screening, management of TB and comorbidities, access to health care, universal health coverage, determinants of TB, TB-associated impairment and disability, social protection, as well as ethics, equity and human rights.
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This guide presents new knowledge and guidelines on the provision of care to persons living with HIV
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/AIDS, in accordance with the last guidelines of the World Health Organization (WHO) published in 2006 and adapted to the Rwandan national context. It thus responds to the need by the Ministry of Health to improve the skills of the actors in the health sector as well as the quality of care and antiretroviral treatment offered in both public and private health facilities countrywide.
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