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1
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Current and expected problems such as ageing, increased prevalence of chronic conditions and multi-morbidity, increased emphasison healthy lifestyle and prevention, and substitution for care from hospitals by care provided in the community encourage countries worldwide to develop new models of prima
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ry care delivery. Owing to the fact that many tasks do not necessarily require the knowledge and skills of a doctor, interest in using nurses to expand the capacity of the primary care workforce is increasing. Substitution of nurses for doctors is one strategy used to improve access, efficiency, and quality of care. This is the first update of the Cochrane review published in 2005.
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Primary health care (PHC) is the essential strategy for reorientating health systems and societies to become healthier, equitable, effective and sustainable. In 2018, on the 40th anniversary of the Declaration of Alma-Ata, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) renewed the emphasis on PHC with their strategy,
WHO outlines 14 strategic and operational levers for policy-makers to strengthen PHC. Within each lever, there are multiple potential entry points for targeted actions to address racial discrimination, foster intercultural care, and reduce health inequities experienced by indigenous peoples as well as people of African descent, Roma and other ethnic minorities.
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als.
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HIV testing programmes need to ensure that all clients who test for HIV are provided with correct diagnoses. The accuracy of HIV testing is critical to prevent misdiagnosis, as the consequences of giving an incorrect test result can be serious for clients, HIV testing services, HIV programmes and pu
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blic health.
With the evolution of global HIV epidemiology, HIV testing approaches must also evolve to maintain accuracy and efficiency in population-level diagnosis. Reports suggest that misdiagnosis of HIV status may occur when suboptimal testing algorithms and out-of-date testing strategies are used. As a result of changing epidemiology and declining HIV positivity in testing, WHO recommends all countries use a standard three-test strategy to ensure a PPV of at least 99%, minimizing false-positive misdiagnosis. The WHO-recommended HIV testing strategy, along with quality assurance measures such as retesting to verify a positive diagnosis prior to initiation of HIV treatment, is cost-effective as it prevents misdiagnosis and unnecessary initiation of costly lifelong treatment.
This implementation guide provides practical advice on switching to a three-test strategy and instituting other measures that can help national HIV programmes deliver high-quality, accurate HIV testing services and ensure that misdiagnosis is minimized.
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In Sierra Leone, Health care delivery is organized around a three-tier system i) primary level constituting peripheral health units (community health centers, community health posts, and maternal and child health posts secondary level constituting district hospitals tertiary level comprising region
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al and national referral hospitals [Figure 3].
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Panel Recommendations
В сводном руководстве изложены меры общественного здравоохранения применительно к ВИЧ-инфекции, вирусным гепатитам и инфекциям, передаваемым половым путем (ИПП
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П), для пяти следующих ключевых групп населения: мужчины, практикующие половые контакты с мужчинами; трансгендерные и гендерно разнообразные люди; секс-работники и работницы; люди, употребляющие инъекционные наркотики; люди, находящиеся в местах лишения свободы и других учреждениях закрытого типа.
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FORTBILDUNG – SCHWERPUNKT TUBERKULOSE HIV & More
Programmatic update
April 2012
Executive Summary
Information note
Accessed November 2017.
National Response Efforts to Address Sexual Violence and Exploitation Against Children in Lesotho: A Desktop Study
Weber, Stephanie
Arlington, VA: USAID’s AIDS Support and Technical Assistance Resources, AIDSTAR-One, Task Order 1
(2013)
C2
Scant data exists on the prevalence of violence against children worldwide. However, available information, including the United Nations Secretary-General’s Study on Violence against Children, shows that violence against children is a global problem. This desktop study aims to glean from published
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and grey literature the extent of sexual violence and exploitation against children in Lesotho. The goal of this study is to better understand the government of Lesotho's national response efforts to reduce violence against children.
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