Hacia respuestas al VIH y a la tuberculosis que transformen las relaciones de género
ORIENTAÇÕES PRÁTICAS PARA INTERVENÇÕES COLABORATIVAS
This Toolkit is intended to guide humanitarian programme managers and healthcare providers to ensure that sexual and reproductive health interventions put into place both during and after a crisis are responsive to the unique needs of adolescents.
La Ceiba – Honduras, 20 - 22 de febrero, 2013
Trabajemos por prisiones y países libres de tuberculosis
Este relatório confere uma visão geral estado da epidemia HIV/SIDA em Moçambique e de como tem sido feita a resposta nacional à epidemia. Cobre também as boas práticas neste campo, tal como os principais desafios e acções correctivas.
(actualizado en diciembre de 2014).
Um Manual Programático
A publicação deste documento foi possível graças ao apoio da Comissão Europeia (auxílio Sante 2007141-838). O conteúdo deste documento é de responsabilidade única de A Union e não reflete a opinião da Comissão Europeia.
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 expan...ding 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.
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Evidence shows that oral pre-exposure prophylaxis (PrEP) reduces the risk of contracting HIV during sexual intercourse by more than 90% when taken daily. It is for this reason the National HIV Prevention Strategy 2015-2020 (2018 Revision) emphasises the role of preexposure prophylaxis (PrEP) in ...reducing new HIV infections in Malawi.
The Ministry of Health has prioritised PrEP use among the populations most at-risk of HIV infection in Malawi: young women ages 10 to 24 years, sero-discordant couples, female sex workers, men who have sex with men, and other priority populations (such as members of the uniformed services, prisoners, and mobile populations).
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This document defines the framework for Malawi’s National HIV Programs. Considering public health benefits and risks, as well as funding and resource implications, deviations from these guidelines are not supported by the Ministry of Health.