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1
Second Edition
Good Policy and Practice in HIV & AIDS and Education
In 1989, the Republic of Benin was facing a great social and
economical crisis. Civil servants of all the sectors in public
administration were on strike. People did not know where to
go for their health care. Salaries were not paid for more than
six months and life for the general population wa
...
s very dificult.
The country was about to degenerate into civil war as a
result of the civil unrest in the country.
Thanks to the assistance from the French, and Canadian
and American Mennonite missionaries, the Bethesda Health
Centre was started in 1990 with US$ 1,000 granted by theses
partners. Today, the Health Centre of Bethesda has expanded
and has become a large Hospital in Cotonou. It hosts each
year about 100,000 patients and has developed the department
of paediatrics, ophthalmology, stomatology, cardiology,
obstetrical gynaecology, X-rays, etc. The Hospital has also
put in place an AIDS service which has been promoted by the
government to the status of an AIDS Treatment Centre.
In an integrated vision, Bethesda has established other departments.
In 1993, the Sanitation department was established
to implement sanitation and environmentally-friendly
projects aimed at reducing the high incidence of some diseases
frequently treated at the hospital. In 1996, the decision
was made to establish a micro-inance department called
PEBCo. This initiative, which currently has 10,000 clients,
uses community savings to promote income-generating activities.
Since many women were obliged to use the loans for
family needs (health care, children schooling, etc.), they were
unable to reimburse them as planned. Hence the Bethesda
non-government organization (NGO) recently began an initiative
to provide a community-based health insurance option
for the population in 2006. There are now 12,000 members.
This paper focuses on the presentation of Benin and the program,
but also describes how the project could be better improved
and what were its beneits and impacts.
Field Actions Science Reports
The journal of field actions
Vol. 4 | 2010
Vol. 4
more
Der Klimawandel und seine Folgen bedrohen schon heute Millionen von Menschen weltweit. Wissenschaftler/-innen warnen seit Jahren davor, dass ein ungebremster Klimawandel die Welt ins Chaos führen wird. Obwohl der Klimaschutz seit Jahren im Zentrum der öffentlichen Debatte steht und auch weltweit i
...
n unzähligen Initiativen, Aktionsplänen und konkreter Politik Berücksichtigung findet, steigt der Ausstoß klimaschädlicher Treibhausgase nach wie vor.
more
Der Klimawandel verschärft die Treiber für Migration und Flucht
Zu den ohnehin bestehenden Gründen, die Menschen zum Verlassen ihrer Heimat zwingen, kommt der Klimawandel verschärfend hinzu. Schätzungen zur Rolle des Klimawandels sind wegen der Komplexität des Zusammenspiels verschiedener Mig
...
rations- oder Fluchtursachen äußerst schwierig. Die Vorhersagen über das mögliche Ausmaß von Migration infolge des Klimawandels gehen daher weit auseinander – bis zum Jahr 2050 könnten zwischen 25 und 700 Millionen Menschen davon betroffen sein (micle 2012).
more
Kaum ein Jahr vergeht inzwischen, ohne dass von neuen Rekorden bei Extremwetterereignissen berichtet wird. Naturkatastrophen und Wetterextreme werden insgesamt immer häufiger und nehmen an Stärke zu – und der Klimawandel spielt dabei eine immer größere und zerstörerische Rolle. Wie schlimm di
...
e Katastrophen die Menschen treffen, wird jedoch nicht nur durch ihre Häufigkeit und Stärke bestimmt. Auch die „Verwundbarkeit“ der Länder und der Menschen gegenüber den Auswirkungen der Naturkatastrophen ist ausschlaggebend für das Maß der Zerstörung (IPCC 2012). Die Erfahrungen aus den vergangenen Katastrophen und die Vorhersagen für die Zukunft zeigen dabei, dass die verwundbarsten Länder gleichzeitig zu den ärmsten der Welt gehören. Um die schlimmsten Auswirkungen durch klimawandelbedingte Naturkatastrophen in den Entwicklungsländern noch zu verhindern, muss der Klimawandel soweit wie möglich begrenzt werden. Klimaschutz ist eine Voraussetzung für nachhaltige Entwicklung und eine Welt ohne Armut und Hunger.
more
Large-Scale UN Response Needed to Address Health and Food Crises
This report is based on interviews with more than 150 health care professionals, Venezuelans seeking or in need of medical care who recently arrived in Colombia and Brazil, representatives from international and nongovernmental humani
...
tarian organizations. In addition, researchers analyzed data on the situation inside Venezuela from official sources, hospitals, international and national organizations, and civil society organizations.
We found a health system in utter collapse with increased levels of maternal and infant mortality; the spread of vaccine-preventable diseases, such as measles and diphtheria; and increases in numbers of infectious diseases such as malaria and tuberculosis (TB). Although the government stopped publishing official data on nutrition in 2007, research by Venezuelan organizations and universities documents high levels of food insecurity and child malnutrition, and available data shows high hospital admissions of malnourished children.
more
Palliative care for older people: better practices
Hall, S.; H. Petkova, A.D. Tsouros, et al.
World Health Organization WHO, Regional Office for Europe, et al.
(2011)
C_WHO
This publication aims to provide examples of better palliative care practices for older people to help those involved in planning and supporting care-oriented services most appropriately and effectively. Examples have been identifi ed from literature searches and from an international call
...
for examples through various organizations, including the European Association of Palliative Care and the European Union Geriatric Medicine Society. Some examples consider how to improve aspects within the whole health system; specifi c smaller examples consider how to improve palliative care education, support in the community, in hospitals or for specifi c groups of people, such as people in nursing homes and people with dementia and their families. Some examples await rigorous evaluation of effectiveness, and more research is needed in this fi eld, especially the cost–effectiveness and generalizability of these initiatives.
more
Minimum standards of home care for older people in Red Cross Red Crescent volunteer-based programming in the Europe Zone
This guide has been written to provide information and practical advice on developing and delivering local plans an strategies to commission the most effective and efficient older people’s mental health services.Based upon clinical best practice guidance and drawing upon the range of available evi
...
dence, it describes what should be expected of an older people’s mental health service in terms of effectiveness, outcomes and value for money.
more
The HEARTS technical package provides a strategic approach to improving cardiovascular health in countries. It comprises six modules and an implementation guide. This package supports Ministries of Health to strengthen CVD management in primary health care settings. The practical, step-by step modul
...
es are supported by an overarching technical document that provides a rationale and framework for this integrated approach to the management of NCDs.
more
In many low- and middle-income countries, there is a wide gap between evidencebased recommendations and current practice. Treatment of major CVD risk factors remains suboptimal, and only a minority of patients who are treated reach their target levels for blood pressure, blood sugar and blood choles
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terol.
In other areas, overtreatment can occur with the use of non-evidence-based
protocols. The aim of using standard treatment protocols is to improve the quality
of clinical care, reduce clinical variability and simplify the treatment options,
particularly in primary health care. Standard treatment protocols can be developed by preparing new national treatment guidelines or by adapting or adopting international guidelines.
The Evidence-based protocols module uses hypertension and diabetes screening
and treatment as an entry point to control cardiovascular risk factors, prevent target organ damage, and reduce premature morbidity and mortality. A comprehensive risk- based approach for integrated management of hypertension, diabetes, and high cholesterol is included in the Risk-based CVD management module.
This module includes clinical practice points and sample protocols for:
1. hypertension detection and treatment
2. type 2 diabetes detection and treatment
3. identifying basic emergencies – care and referral.
HEARTS emphasizes adaptation, dissemination, and use of a standardized set of
simple clinical-management protocols, which should be drug- and dose-specific,
and include a core set of medications. The simpler the protocols and management tools, the more likely they are to be used correctly, and the higher the likelihood that a programme will achieve its goals.
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Procurement and supply management activities are fundamental to consistent and reliable access to essential medicines and health products. To reduce the impact of CVD, action needs to be taken to improve prevention, diagnosis, care and management of CVD diseases. Affordable essential medicines and t
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echnologies to manage CVD disease must be available where and when they are required. Medicines and technologies need to be managed appropriately to ensure that the correct medicines are selected, procured in the right quantities, distributed to facilities in a timely manner, and handled and stored in a way that maintains their quality. This needs to be backed up by policies that enable sufficient quantities to be procured in order to reduce cost inefficiencies, ensure the reliability and security of the distribution system, and encourage the appropriate use of these health products. In order to avoid stock-outs and the disruption of treatment, all related activities need to be conducted in a timely manner, with performance continually monitored, and prompt action taken in response to problems that may arise. Additionally, medication must be dispensed correctly and used rationally by the healthcare provider and patient alike. The purpose of this guide is to explain the necessary steps.
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HEARTS provides a set of locally adaptable tools for strengthening the
management of CVD in primary health care.
HEARTS is designed to enhance implementation of WHO PEN by providing:
• operational guidance on further integrating CVD management
• technical guidance on evaluating the impact of
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CVD care on patient outcomes.
For countries not using WHO PEN, CVD management can still be integrated into
primary health care. The process of implementing HEARTS will vary, depending
on country context, and may require a significant reorienting and strengthening
of the health system. At some sites, existing CVD management services may be
reoriented toward a risk-based approach, while other sites may adopt a public
health approach, strengthening management of particular risk factors such as
hypertension. Whether or not introducing CVD management into primary care is a
new intervention, successful implementation will require engagement with national and local health planners, managers, service providers, and other stakeholders.
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Guide technique pour la prise en charge des maladies cardiovasculaires dans le cadre des soins de santé primaires
Estimating the impact of expanded access to antiretroviral therapy on maternal, paternal and double orphans in sub-Saharan Africa, 2009-2020
Aranka Anema1,2*, C. G. Au-Yeung; M. Joffres; et al.
BMC Medicine; AIDS Research and Therapy
(2011)
CC
Anema et al. AIDS Research and Therapy 2011, 8:13 http://www.aidsrestherapy.com/content/8/1/13
A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association
AHA/ASA Guideline
DOI: 10.1161/STR.0000000000000158
Guidance for orphans and vulnerable children programming
PEPFAR
(2012)
C2
The U.S. President‘s Emergency Plan for AIDS Relief
Journal of Infection and Public Health 12 (2019) 213–223