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Background: Comparable estimates of health spending are crucial for the assessment of health systems and to optimally deploy health resources. The methods used to track health spending continue to evolve, but little is known about the distribution o
...
f spending across diseases. We developed improved estimates of health spending by source, including development assistance for health, and, for the first time, estimated HIV/AIDS spending on prevention and treatment and by source of funding, for 188 countries.
more
AIDS 2024, 38:1579–1588. Treatment interruptions are a barrier to successful antiretroviral therapy (ART). 'Fresh start messages', which leverage significant days on the calendar (e.g., new year, public holiday) in order to prompt action, have the
...
potential to encourage people with HIV (PWH) to return to care. We evaluated a 'fresh start' intervention (text messages) to increase return to care in PWH who had missed their last appointment.
more
In the area of nutrition and HIV, children deserve special attention because of their additional needs to ensure growth and development and their
...
dependency on adults for adequate care. It was therefore proposed to first develop guidelines for children and thereafter consider a similar approach for other specific groups.
The content of these guidelines acknowledges that wasting and undernutrition in HIV-infected children reflect a series of failures within the health system, the home and community and not just a biological process related to virus and host interactions. In trying to protect the nutritional well-being or reverse the undernutrition experienced by infected children, issues of food insecurity, food quantity and quality as well as absorption and digestion of nutrients are considered. Interventions are proposed that are practical and feasible in resource-poor settings and offer a prospect for clinical improvement.
The guidelines do not cover the feeding of infants 0 to 6 months old, because the specialised care in this age group is already addressed in other WHO guidelines and documents.
more
Using Community Health Workers to Improve Linkage and Retention in Care Implementation Resources
Boston University School of Social Work Center for Innovation in Social Work and Health
AETC Program
(2020)
CC
Implementation tools developed by the Boston University School of Social Work Center for Innovation in Social Work and Health under the HRSA HAB Special Projects of National Significance initiative.
The manual is written for clinicians working at the district hospital (first-level referral care) who diagnose and manage sick adolescents and adul
...
ts in resource constrained settings. It aims to support clinical reasoning, and to provide an effective clinical approach and protocols for the management of common and serious or potentially life-threatening conditions at district hospitals. The target audience thus includes doctors, clinical officers, health officers, and senior nurse practitioners. It has been designed to be applicable in both high and low HIV prevalence settings.
Volume 2 provides a symptom-based approach to clinical care for acute and subacute conditions (including mental health). It provides short summaries of the management of diseases that affect multiple systems of the body, focusing on communicable diseases. It also includes the chronic or long-term management of HIV, TB, alcohol, and substance use disorders.
more
Pregnancy and childbirth during adolescence profoundly affects the lives of millions of girls worldwide, and is a leading cause of maternal mortality and
...
morbidity, and infant and child mortality. Every year, an estimated 21 million girls aged 15–19 years old in low- and middle-income countries become pregnant, and approximately 12 million give birth.
For many adolescent girls, the ability to control their sexual lives remains limited. Long-standing gender inequalities and discrimination, marginalization, harmful social and gender norms, and denial of rights, compounded by poverty and violence, render them vulnerable to early pregnancy, HIV and other health threats. Lack of age-appropriate sexual and reproductive health and rights (SRHR) information and services create additional barriers to care and support; as a result, adolescent girls who become pregnant are much more likely to go on to have rapid repeated births.
more
Journal of the International AIDS Society, Volume 20, Issue 1 (2017)21796
Qualitative research on HIV self testing among men who have sex with men and transgender women in Yangon, Mynamar.
Global effort to increase early diagnosis ... and engagement in HIV care emphasize the importance of developing novel approaches to reaching those missed by traditional methods. Such needs are particularly great for men who have sex with men (MSM), transgender women (TW), and other populations who face stigma. Myanmar's HIV epidemic is concentrated among key populations and the revised National Strategy aims to reduce late diagnosis and barriers to care to curb HIV incidence among these groups. HIV self‐testing (HIVST) may be one method to improve testing and diagnosis among key populations, by placing HIV testing and disclosure within the individual's control.
https://doi.org/10.7448/IAS.20.01.21796 more
Qualitative research on HIV self testing among men who have sex with men and transgender women in Yangon, Mynamar.
Global effort to increase early diagnosis ... and engagement in HIV care emphasize the importance of developing novel approaches to reaching those missed by traditional methods. Such needs are particularly great for men who have sex with men (MSM), transgender women (TW), and other populations who face stigma. Myanmar's HIV epidemic is concentrated among key populations and the revised National Strategy aims to reduce late diagnosis and barriers to care to curb HIV incidence among these groups. HIV self‐testing (HIVST) may be one method to improve testing and diagnosis among key populations, by placing HIV testing and disclosure within the individual's control.
https://doi.org/10.7448/IAS.20.01.21796 more
Men lag behind women regarding use of HIV services and represent the majority of individuals living with uncontrolled HIV, advanced HIV, and who experience HIV-related mortality. Men (15+) globally
...
are less likely than women (15+) to know their HIV status (83% for men vs 91% for women), be on antiretroviral treatment (ART) (72% for men vs 83% for women) and reach viral suppression (67% for men vs 78% for women).
more
The content of these guidelines acknowledges that wasting and undernutrition in HIV-infected children reflect a series of failures within the health system, the home and community
...
and not just a biological process related to virus and host interactions.
The guidelines do not cover the feeding of infants 0 to 6 months old, because the specialised care in this age group is already addressed in other WHO guidelines and documents.
more
Integrating violence against children prevention and response into HIV services. Participant manual
recommended
This training seeks to equip health workers who have contact with children in HIV settings with the knowledge and skills to better integrate violence against children (VAC) services into their work. It seeks to transmit information
...
and skills to make them: feel comfortable talking with, providing services and making appropriate referrals to children and their caregivers who are at risk of or experiencing violence.
This three-day training package includes ten modules to be delivered to groups of 25-30 health workers. The training is aimed at different cadres of health workers, including: nurses and midwives; clinicians; HIV counselors; medical social workers; pharmacists; community health workers, and others who are involved in children’s health care in health settings
more
July 2023 version .The 2023 ART guideline introduces simplified ART provision and harmonised methods of management of children, adolescents and adults, as well as pregnant women living with
...
HIV/AIDS, TB and other common opportunistic infections.
The guidelines also provide guidance on the use of Dolutegravir (DTG) dispersible tablets for children from 3kg and 4 weeks old.
These guidelines have been revised with the Differentiated Models of Care SOPs to ensure simultaneous consideration and alignment of clinical, adherence and service delivery updates.
more
Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of
...
a CHW programme. In this study, we evaluated expanding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
more
Open Forum Infect Dis . 2022 Apr 5;9(5):ofac148.doi: 10.1093/ofid/ofac148. eCollection 2022 May. Dolutegravir HIV drug resistance (HIVDR) data from Africa remain sparse. We reviewed HIVDR results of Malawians on dolutegravir-based antiretroviral therapy (November 2020– September 2021). Of 6462 eli
...
gible clients, 33 samples were submitted to South Africa, 27 were sequenced successfully, and 8 (30%) had dolutegravir HIVDR. Malawi urgently requires adequate HIVDR testing capacity.
more
In 2020, the COVID-19 pandemic impacted the world beyond imagination. To date, it has infected more than 135 million people, killed over 2.9 million people, and is projected to plunge up to 115 million people into extreme poverty.1 As countries have
...
gone into lockdown, gender-based violence has increased, unemployment has soared, and access to health care for the poorest and most vulnerable has been cut. COVID-19 has made people less likely to seek health care because they are afraid of getting infected with the virus. Fear and uncertainty surrounding COVID-19 have also increased stigma and discrimination. As frontline workers without enough access to personal protective equipment (PPE) risk their lives to treat patients, the virus pushes already fragile health systems to the brink.
more
The adopted pillars for the AEVT Plan are a) early testing among children exposed to HIV, syphilis and HBV; b) closing the treatment gap among PBFW and
...
children exposed to HIV, syphilis and HBV; c) prevention of new HIV, syphilis and HBV infections among PBFW; and d) breaking down barriers to access to integrated services. Based on these pillars, the AEVT plan guides galvanizing political advocacy for the last mile toward the elimination of vertical transmission of HIV, syphilis and HBV in Africa by 2030
more
This implementation tool describes the recommended approaches for routine monitoring of toxicity integrated with the national monitoring and evaluation system and targeted approaches to monitoring t
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oxicity to enable enhanced monitoring and reporting of treatment-limiting toxicity to support country implementation and generation of local data.
more
While many of the countries hit by the COVID-19 in the first few months of the year are now beginning to relax lockdown measures as infection and death rates fall, in the regions most affected by HIV, TB a
...
nd malaria, such as Africa, South Asia and Latin America, the pandemic continues to accelerate. In lower resource settings, lockdowns are less effective and hard to sustain, and clinical care facilities are extremely limited. In such environments, the response to COVID-19 must focus on containing the pandemic’s spread as far as possible through testing, contact tracing and isolation, protecting the health workforce through training and the provision of personal protective equipment (PPE) and minimizing the knock-on impact on other diseases through shoring up fragile health systems, and adapting existing disease programs.
more
Ghana's attempt to regulate health care waste management started in 2002 with the development of guidelines on health care waste manage-ment by the Environmental Protection Agency (EPA). In 2006, th
...
e Ghana Health Service (GHS) also developed the Health Care Waste Management Policy and Guidelines as a single document.
Although awareness on Health Care Waste Management (HCWM) has improved in recent years, there is the need for a systematic approach to improve on effective segregation, safe collection, and storage, as well as ultimate treatment before disposal.
This guideline seeks to ensure that HCW is managed effectively in compliance with existing International Conventions that Ghana is a signatory to, national laws and regulations, and others to be passed in future.
Recommendations for better management of HCW in the nation's health care facilities have been presented in this document. Also, standard operating procedures (SOPs) have been developed to provide
guidance to various levels of the health facilities.
more
An output of a series of workshops on psychosocial support held in 2004-2005 by the Bernard van Leer Foundation and the Coalition on Children Affected by AIDS. Authors Linda Richter, Geoff Foster and
...
Lorraine Sherr discuss the issues surrounding psychosocial care and support for children made vulnerable by the HIV/AIDS pandemic and make recommendations for future priorities and programming directions. Includes the ""Call To Action"" for Toronto 2006.
more
