The uneven distribution of HIV risks and burdens across populations is a well-substantiated fact, though seldom publicly acknowledged. Gay men and other men who have sex with men, people who inject drugs, sex workers, and transgender women are 24, 24, 13.5, and 49 times more likely to acquire HIV, ...respectively, than other reproductive aged adults (15 years old and older). Globally, new infections among these key populations account for 45% of all new HIV infections. This figure is likely to be an underestimate, given the intense stigma associated with disclosing and reporting acquisition risks for HIV among gay men, people who use drugs, sex workers, and transgender people. In addition, HIV epidemics in the majority of low- and middle-income countries (90 of 120) have concentrated epidemics among key populations. In countries with more broadly generalized epidemics, risks are still not evenly distributed and key populations still shoulder disease burden that is markedly disproportionate.
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From 2000 to 2010, Rwanda implemented comprehensive health sector reforms to strengthen the public health system, with the aim of reducing maternal and newborn deaths in line with Millennium Development Goal 5, among many other improvements in national health. Based on a systematic review of the lit...erature, national policy documents and three Demographic & Health Surveys (2000, 2005 and 2010), this paper describes the reforms and the policies they were based on, and provides data on the extent of Rwanda’s progress in expanding the coverage of four key women’s health services. Progress took place in 2000–2005 and became more rapid after 2006, mostly in rural areas, when the national facility-based childbirth policy, performance-based financing, and community-based health insurance were scaled up. Between 2006 and 2010, the following increases in coverage took place as compared to 2000–2005, particularly in rural areas, where most poor women live: births with skilled attendance (77% increase vs. 26%), institutional delivery (146% increase vs. 8%), and contraceptive prevalence (351% increase vs. 150%). The primary factors in these improvements were increases in the health workforce and their skills, performance-based financing, community-based health insurance, and better leadership and governance. Further research is needed to determine the impact of these changes on health outcomes in women and children.
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There is no guarantee that a successful pilot program introducing a reproductive health innovation can also be expanded successfully to the national or regional level, because the scaling-up process is complex and multilayered. This article describes how a successful pilot program to integrate the S...tandard Days Method (SDM) of family planning into existing Ministry of Health services was scaled up nationally in Rwanda.
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Health Systems for Outcomes Publication | Using qualitative data from Rwanda, this study focuses on four institutional factors that affect health worker performance and career choice: incentives, monitoring arrangements, professional norms and health workers’ intrinsic motivation. It also provides... illustrations of three institutional innovations that work, at least in the context of Rwanda: performance pay, the establishment of community health workers and increased attention to the training of health workers.
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The objective of the evaluation is to understand whether the CHW program has achieved its intended objectives, thus contributing to the overarching objectives defined in the HSSP III of improving the health status of the population by “Ensuring universal accessibility of quality health services fo...r all Rwandans”.
This evaluation has focused on CHWs, who are selected, trained and deployed by the MoH to deliver a defined set of tasks at community level. CHWs are the central element of the Community Health Policy and of the community health strategy plan (CHSP) of the MoH.
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The purpose of this report is to provide an overview of the issues in regulating and managing international emergency in a selection of large and small-scale sudden onset disasters (SODs). In doing so, it aims to contribute to several key international commitments as well as its objective in disaste...rs and emergencies to “reduce the consequences the event may have on world health and its social and economic implications”.
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These National Operational Guidelines for Viral Load Testing detail how routine viral load testing will be implemented at the facility level in India. They include frequency and interpretation of monitoring, sample collections, storage and transportation, receipt of results, adherence counseling, an...d reporting requirements. Roles and responsibilities are outlined as well as turnaround time requirements.
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This study explored family adjustment and access to rehabilitative services for children with Down syndrome, between 0-5 years of age, in the ecoculture of Petchaburi Province, Thailand.
This guide includes information relevant for tuberculosis (TB) program and laboratory managers, as well as Ministry of Health officials across disease programs interested in establishing integrated solutions for specimen referral. Though TB-focused in name, it offers integration-oriented assessment,... design, and monitoring guidance related to improving coordination and efficiency, and is relevant for other programs as well. Country case studies include viral load and early infant diagnosis (EID) in Uganda and EID in Ethiopia.
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An action research conducted in Bang Shau village Northern Shan State, Myanmar
Informationen für ÄrztInnen und PsychotherapeutInnen. Diese Broschüre informiert über die Situation von Flüchtlingen in Deutschland, darüber, wie sich traumatische Erlebnisse bei Flüchtlingen auf die Gesundheit und das alltägliche Leben auswirken können und wie dies die ärztlichen und psyc...hotherapeutischen Beziehungen beeinflussen kann. Sie liefert Informationen zu Rahmenbedingungen der Behandlung, die es zu berücksichtigen gilt, wie den Aufenthaltsstatus und die damit einhergehende Kostenträgerschaft für ärztliche, psycho-therapeutische und auch Dolmetscherleistungen.
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The aim of this paper is to map and critically analyse evidence of good practice in prevention and response to gender-based violence (GBV) in humanitarian contexts which can support humanitarian practitioners and policy makers to improve the quality of GBV programming in the field. The paper is stru...ctured as follows. Following a brief discussion of key concepts and definitions in relation to GBV, Chapter 2 presents an overview of the extent of GBV in emergencies, and some of the challenges in responding to the problem. Chapter 3 then analyses some of the literature on the evidence of GBV programming effects in humanitarian settings, and draws out key lessons with regard to good practice. Chapter 4 discusses some of the key issues emerging from this review, and Chapter 5 concludes the paper with a discussion of the implications of the findings for research, policy and programming on GBV.
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Standard Treatment Guideline
The objectives of the scheme is to promote cleanliness, hygiene and infection control practices in public health care facilities, to incentivize and recognize such public healthcare facilities that show exemplary performance in adhering to standard protocols of cleanliness and infection control, to... inculcate a culture of ongoing assessment and peer review of performance related to hygiene, cleanliness and sanitation, to create and share sustainable practices related to improved cleanliness in public health facilities linked to positive health outcomes.
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