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Toolboxes
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Powerpoint Presenation for Training
Downloaded free from http://www.j-hhr.org on Monday, March 06, 20
Journal of HIV and Human Reproduction: Year : 2015, volume : 3, Issue : 2, Page : 47-55
National AIDS and STI Control Program
This guide presents new knowledge and guidelines on the provision of care to persons living with HIV/AIDS, in accordance with the last guidelines o
...
f the World Health Organization (WHO) published in 2006 and adapted to the Rwandan national context. It thus responds to the need by the Ministry of Health to improve the skills of the actors in the health sector as well as the quality of care and antiretroviral treatment offered in both public and private health facilities countrywide.
more
The target audience for this guideline is primarily for health care providers nurses, doctors, social workers and other people involved in HIV response in Rwanda so that they are capable of offering quality care services to patients over a long time
...
. The new National Guidelines for Prevention and Management of HIV and STIs are articulated in accordance to treat all HIV+ patients regardless of CD4 count and a new service delivery model to support its implementation.
more
Biobehavioural Survey Guidelines - For Populations at risk for HIV
A. Abdul-Quader; M. Berry; T. Bingham; J. Burnett; et al.
Centers for Diseases Control and Prevention; UNAIDS; World Health Organization; et al.
(2017)
C_WHO
Global HIV Strategic Information Working Group
1PEP GUIDELINES | 2019 EDITION. The prevalence of both HIV and Hepatitis B is high in South Africa therefore there is a significant risk of acquiring these infections following exposure to infected
...
material. Studies suggest that post- exposure prophylaxis (PEP) with highly active antiretroviral treatment (HAART) is highly effective in preventing HIV infection if taken correctly for the full recommended duration of 28 days, and that prophylaxis with Hepatitis B immunoglobulin and vaccination may prevent Hepatitis B infection if given soon after exposure. This update of the Western Cape guidelines for management of potentially infectious exposures is based on current evidence and guidelines issued by the WHO, NDoH and the SA HIV Clinicians Society. The key aim is to promote successful completion of the recommended ART regimen in the 28 day period of therapy, as well as prevent infection with Hepatitis B
more
- A Skills Building Program for Clinicians and Non-Clinicians. Adherence guidelines- slide deck- training course for health providers
The Consolidated guidelines on HIV, viral hepatitis and STI prevention, diagnosis, treatment and care for key populations outline a public health response for 5 key populations (men who have sex wit
...
h men, trans and gender diverse people, sex workers, people who inject drugs and people in prisons and other closed settings). They present and discuss new recommendations and consolidate a range of recommendations and guidance from current WHO guidelines.
more
These policy guidelines provide a strategic approach and new recommendations for integrated TB and HIV services for patients suffering from substance-abuse addiction. The key recommendations fall un
...
der three main categories: joint planning, key interventions, and overcoming barriers.
more
Epidemiology
Chagas disease (American trypanosomiasis) is caused by the protozoan parasite Trypanosoma cruzi, and transmitted to humans by infected triatomine bugs, and less commonly by transfusion, organ transplant, from mother to infant, and in rare instances, by ingestion of contaminated food or
...
drink.1-4 The hematophagous triatomine vectors defecate during or immediately after feeding on a person. The parasite is present in large numbers in the feces of infected bugs, and enters the human body through the bite wound, or through the intact conjunctiva or other mucous membrane.
Vector-borne transmission occurs only in the Americas, where an estimated 8 to 10 million people have Chagas disease.5 Historically, transmission occurred largely in rural areas in Latin America, where houses built of mud brick are vulnerable to colonization by the triatomine vectors.4 In such areas, Chagas disease usually is acquired in childhood. In the last several decades, successful vector control programs have substantially decreased transmission rates in much of Latin America, and large-scale migration has brought infected individuals to cities both within and outside of Latin America.
more
Guidelines for national programmes and other stakeholders, for annexes see http://www.who.int/tb/publications/2012/tb_hiv_policy_9789241503006/en/
AIDS Research and Therapy 2015, 12:12 (24 April 2015)
The main aim of these guidelines is to enable the central units of national TB and HIV/AIDS programmes to support districts to plan, coordinate and implement collaborative TB/
...
HIV activities. These guidelines reinforce current medical understanding, that highly active antiretroviral treatment (HAART) has decreased TB incidence of people living with HIV/AIDS. They are comprehensive, giving an overview of the range of activities that could be undertaken in high burden TB/HIV countries or where a rising prevalence of HIV might fuel TB. Activities highlight the need for comprehensive care, prevention and support for adults living with HIV/AIDS. Comprehensive TB and HIV care and prevention rely on full implementation of the DOTS strategy as part of a wide ranging HIV/AIDS care and prevention programme as well as collaborative TB and HIV programme activities.
more
Handbook - Guidelines for an Integrated Approach to the Nutritional care of HIV-infected children (6 months-14 years)
World Health Organization
(2009)
Preliminary version for country introduction
Guidelines on Estimating the Size of Populations Most at Risk to HIV
UNAIDS; World Health Organization
(2010)
C_WHO
UNAIDS/WHO Working Group on Global HIV/AIDS and STI Surveillance
An Examination of 13 Projects in PEPFAR-Supported Countries
Downloaded from https://aidsinfo.nih.gov/guidelines on 10/19/2019
Recommendations from the National Institutes of Health, Centers for Disease Control and Prevention, the HIV Medicine Association
...
of the Infectious Diseases Society of America and the Pediatric Infectious Diseases Society
(This guideline was simultaneously published in The Pediatric Infectious Disease Journal on November 6, 2013.)
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
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 bio
...
logical 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
Skin and mucosal conditions are extremely common in all children and adults in particular in HIV-infected adults and children and are one of the commonest daily management problems faced by health care workers caring for patients with
...
HIV infection
more
The target audience for this training course is non-clinicians such as Home Based Carers, Community Caregivers, Youth Care Workers, Peer educators, Community Health Workers etc. primarily those who will be providing adherence counselling to clients with HI
...
V, TB, Hypertension and Diabetes. This group of non-clinicians play a vital role in helping to reduce the workload of nursing staff. Amongst others, non- clinicians educate clients and provide emotional support in a manner that makes each client feel like they are receiving focused, individual attention. Non-clinicians are often in close contact with communities and, therefore, able to understand and play a role in alleviating health service barriers in the community.
Facility managers may also be part of the target audience in order to ensure that they understand the components of the minimum package of interventions to support linkage, adherence and retention in care.
Further, their attendance seeks to ensure that non-clinicians receive necessary assistance and support when they have to implement what they have learned back into their workplaces.
more
STANDARD OPERATING PROCEDURES
PARTICIPANT GUIDE
This Participant Guide has been designed to assist health facilities and community based non-clinicians to develop skills to provide linkage to care, adherence and retention in care services for chronic conditions
Retest and treat: a review of national HIV retesting guidelines to inform elimination of mother-to-child HIV transmission (EMTCT) efforts
A. L. Drake; K. A. Thomson; C. Quinn; et al.
Journal of the International AIDS Society; PubMed.gov
(2019)
C2
Review
Drake AL et al. Journal of the International AIDS Society 2019, 22:e25271 http://onlinelibrary.wiley.com/doi/10.1002/jia2.25271/full | https://doi.org/10.1002/jia2.25271
Основная цель этого Руководства состоит в том, чтобы очертить рамки методов, используемых для оценки распространенности ВИЧ-инфекции среди больных туберкулезом и
...
способствовать осуществле-нию эпиднадзора за ВИЧ-инфекцией.
more
The goal of this addendum is to help management and staff
minimize the risk of TB transmission at facilities in resource limited settings in which a.) HIV-infected persons receive diagnosis, care, treatment,
and/or support, and b.) there is a
...
high prevalence of HIV infection, both known
and undiagnosed, in settings such as prisons, jails, other
detention centers, and drug rehabilitation centers.
more
Chagas disease (American trypanosomiasis) is caused by the protozoan parasite Trypanosoma cruzi, and transmitted to humans by infected triatomine bugs, and less commonly by transfusion, organ transplant, from mother to infant, and in rare instances, by ingestion of contaminated food or drink.1-4 The
...
hematophagous triatomine vectors defecate during or immediately after feeding on a person. The parasite is present in large numbers in the feces of infected bugs, and enters the human body through the bite wound, or through the intact conjunctiva or other mucous membrane.
more
The Panel recommendations on initial combination regimens for the antiretroviral therapy (ART)-naive, HIV-infected patients.
South African National TB Guidelines - Children
Medicines Information Centre; SPES Bona; National HIV & TB Health Care Worker Hotline
(2019)
C2
Accessed: 08.10.2019
Based on the National Guidelines for the Management of Tuberculosis in Children 2013, Department of Health, South Africa.
HIV and adolescents: Guidance for HIV testing and counselling and care for adolescents living with HIV
World Health Organization
(2013)
These guidelines provide specific recommendations and expert suggestions — for national policy-makers and programme managers and their partners and stakeholders— on prioritizing, planning and providing
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HIV testing, counselling, treatment and care services for adolescents
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This technical note summarizes the consolidated guidelines and adapts them to the context of Latin America and the Caribbean, in order to adequately monitor the number of people on ART. For this purpose, guidance is presented on the indicators and t
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he methodology to know more precisely the number of people who are in ART.
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The guidelines acknowledge that overcrowding, unhygienic conditions and high inmate turn over contribute to the spread of infectious diseases within correctional facilities. The document states that voluntary
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HIV counselling and testing must be offered to all inmates when they enter facilities, during their incarceration at an inmate’s request and upon their release. All inmates must be screened for TB symptoms upon entry to facilities and at least bi-annually thereafter as well as upon release. Universal screening for anal, oral and genital STIs must be done at entry and upon self-presentation
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Policy Guidelines for Health Facilities
Care and Support Centre (CSC) is a national initiative to provide expanded and holistic care and support services for PLHIV. The guideline focuses on the objectives, criteria for selection, required infrastructure, human resources, MIS tools, and financial
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guidelines for CSCs. This guideline will be useful to the care providers, programme managers, and all stakeholders in providing excellent care to the people living with HIV/AIDS
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The Government of Botswana’s SRH Policy Guidelines and Service Standards document provides the framework for developing a responsive strategy and an implementation plan for SRHR and HIV&AIDS Linka
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ges and Integration. The global call on governments to demonstrate commitments to intensify linkages between sexual and reproductive health and HIV&AIDS at the policy and programme level is therefore an added opportunity for the government to review the current service provision model and optimize current resources to provide more integrated, comprehensive coordinated SRHR and HIV&AIDS services.
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Consolidated Guidelines
Geneva, 2016
The End TB Strategy
These guidelines provide new and updated recommendations on the use of point-of-care testing in children under 18 months of age and point-of-care tests to monitor treatment in people living with HIV
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; the treatment monitoring algorithm; and timing of antiretroviral therapy (ART) among people living with HIV who are being treated for tuberculosis.
New recommendations launched today outline key new actions that countries can take to improve the delivery of HIV testing, treatment and care services by providing greater options for differentiated approaches such as, supporting HIV treatment start in the community, ensuring that children are diagnosed and treated early, and that viral load treatment monitoring is more accessible, focused and triggers clinical action
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Guidelines
UNAIDS/WHO working group on global HIV/AIDS and STI surveillance
August 2015
HIV strategic information for impact
Transgender HIV/AIDS Health services
TargetHIV
(2019)
C2
Best Practices Guidelines
Accessed: 06.11.2019
Malawi Integrated Guidelines and Standard Operating Procedures for Providing HIV Services. 3rd edition 2016
The resources provide both the older as well as the updated Operational Guidelines for antiretroviral therapy centres, including administrative issues, functions and establishment of centres, reporting and recording tools, measures to improve retent
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ion in HIV care, supply chain management of drugs and various other aspects that are essential to ensure quality treatment for people living with HIV/AIDS.
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HIV prevention, diagnosis, treatment and care for key populations
World Health Organization; UMAIDS; UNDP; et al.
(2017)
C_WHO
Policy Brief
Consolidated Guidelines
Updated 2016
WHO/HIV/2017.05
Joint WHO/ILO guidelines on post-exposure prophylaxis (PEP) to prevent HIV infection.
The new WHO guidelines recommend that people living with HIV be started on antiretrovirals (ARVs) as soon as possible after being diagnosed. Currently, many people living with the virus globally mus
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t wait until their CD4 counts fall to 500 to start treatment. According to the WHO, the move to early treatment –or what some have dubbed the “test and treat” model –is backed by the latest research.
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National Operational Guidelines
Regulation of the Minister of Home Affairs Number 20 of 2007 concerning General Guidelines for the Establishment of the Commission for the Control of AIDS and Community Empowerment in the Framework of HIV
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and AIDS Control in the Regions
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Regulation of Minister of Women Empowerment and Child Protection
Republic of Indonesia Number 09 Year 2010 on Guidelines for Planning and Budgeting in HIV / AIDS Responsive Prevention and Control
An Addendum to Sexual and Reproductive Health (SRH) Policy Guidelines and Service Standards
Decree of the Minister of Health of the Republic of Indonesia Number 1507 / MENKES / SK / X / 2005 on guidelines for HIV / AIDS counseling and testing services voluntarily
Indonesian Prevention Guidelines on HIV and AIDS
Regulation of the Minister of Health of the Republic of Indonesia Number 74 Year 2014: Guidelines for Implementation of Hiv Counseling and Test
Policy Brief, Updated in March 2017
Key messages
• The criminalisation of male-to-male sex heightens HIV and other sexually transmissible infection (STI) risks and vulnerabilities, and hinders access to ... HIV and STI services including HCT.
• Men who have sex with men (MSM) and transgender persons (TG) are not a homogeneous group. As such, a variety of HCT service models are needed to reach the various segments of these populations.
• Stigma and discrimination remain ongoing issues at a number of service points. Targeted training of service providers is therefore needed so that MSM and TG are not discouraged from seeking HCT and high-quality prevention, treatment and care services.
• Specific guidelines on HIV prevention, treatment and care services for MSM or TG help improve the delivery of services. more
Key messages
• The criminalisation of male-to-male sex heightens HIV and other sexually transmissible infection (STI) risks and vulnerabilities, and hinders access to ... HIV and STI services including HCT.
• Men who have sex with men (MSM) and transgender persons (TG) are not a homogeneous group. As such, a variety of HCT service models are needed to reach the various segments of these populations.
• Stigma and discrimination remain ongoing issues at a number of service points. Targeted training of service providers is therefore needed so that MSM and TG are not discouraged from seeking HCT and high-quality prevention, treatment and care services.
• Specific guidelines on HIV prevention, treatment and care services for MSM or TG help improve the delivery of services. more
Following the encouraging initial results of the pilot project, the Ministry of Health is committed to increasing access to MDR-TB diagnosis, treatment and care. An expansion plan for the programmatic management of drug-resistant TB has been developed and forms part of the Five Year National Strateg
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ic Plan for TB Control, 2011-2015. The long-term goals of the MDR-TB expansion plan are threefold:
1. Diagnosis of MDR-TB in all groups of patients at risk for MDR-TB
2. Diagnosis of MDR-TB in all HIV-infected TB patients
3. MDR-TB treatment for all patients diagnosed with MDR-TB under WHO-endorsed treatment protocols more
1. Diagnosis of MDR-TB in all groups of patients at risk for MDR-TB
2. Diagnosis of MDR-TB in all HIV-infected TB patients
3. MDR-TB treatment for all patients diagnosed with MDR-TB under WHO-endorsed treatment protocols more
Biobehavioural Survey Guidelines
A. Abdul-Quader, M. Berry, T. Bingham; et al.
UNAIDS; World Health Organization; fhi360; et al.
(2017)
C_WHO
Global HIV Strategic Information Working Group
For Populations At Risk For HIV
What recommendations did the assessment produce?
• Developing guidelines and plans to further the process of SRH and Hiv integration.
• Training stakeholders at different levels of the hea
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lth system on how to integrate activities.
• Establishing mechanisms for collaboration/coordination on SRH and Hiv at different levels.
• Developing plans for SRH and Hiv integration that include: situation analysis; feasibility studies; assessment of needs for reorganizing and reorienting services towards better integration; necessary tools (e.g. job descriptions, work plans); and tools to evaluate service quality and user satisfaction in relation to integration.
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Guidelines on care, treatment and support for women living with HIV/AIDS and their children in resource-constrained settings
Guidelines for national programmes and other stakeholders
Annexes for webposting and CD-Rom distribution with the policy guidelines
Guidelines for national programmes and other stakeholders
Annexes for webposting and CD-Rom distribution with the policy guidelines
25 February 2021
This technical guidance is a living document that builds on guidelines and reports of the UNAIDS Joint Programme. The definitions contained herein are working definitions that are subject to change. Updates will also be added furth
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er to the work of the multistakeholder Task Team on community-led AIDS responses that was recently established by the UNAIDS Executive Director and the UNAIDS Joint Programme, and which will conclude its task in December 2021.
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Web annex e. recommendations for use of hormonal contraception for women living with HIV using antiretroviral therapy (ART)
World Health Organization
(2018)
C_WHO
Updated recommendations on first-line and second-line antiretroviral regimens and post-exposure prophylaxis and recommendations on early infant diagnosis of HIV: interim guidelines. Supplement to th
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e 2016 consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection
WHO/CDS/HIV/18.28
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Chronic HIV Care with ARV Therapy and Prevention
World Health Organization
(2007)
C_WHO
Integrated Management of Adolescent and Adult Illness
Integrated Management of Childhood Illness
Interim Guidelines for health workers at health centre or district hospital outpatient clinic
The manual is written for clinicians working at the district hospital (first-level referral care) who diagnose and manage sick adolescents and adults in resource constrained settings. It aims to support clinical reasoning, and to provide an effective clinical approach and protocols for the managemen
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t 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.
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HIV care and support
UNAIDS
(2016)
C2
UNAIDS 2016, Reference
HIV care and support taking into account the 2016 WHO consolidated guidelines
HIV Toolbox
recommended
We have created a special Toolbox on HIV, please click here to see all guidelines, manuals, reports & studies
Guidance for Non-HIV-Specialized Providers Caring for HIV-Infected Residents Displaced from Disaster Areas - Essential Information for Managing HIV-Infected Patients Receiving Antiretroviral Therapy
HHS Panels (*)
(2011)
The following information provides guidance to health care providers attending to the medical needs of HIV-infected adults (including pregnant women) or children displaced from disaster areas who have not yet secured
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HIV care in the areas where they have relocated.
(*)
- HHS Panel on Antiretroviral Guidelines for Adults and Adolescents
- HHS Panel on Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal Transmission
- HHS Panel on Antiretroviral Therapy and Medical Management of HIV-Infected Children
- HHS Panel on Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults & Adolescents
- HHS Panel on Guidelines for the Prevention and Treatment of Opportunistic Infection in HIV-Infected Children
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The duration of breastfeeding and support from health services to improve feeding practices among mothers living with HIV
This operational guidance, developed by WHO, UNICEF and ENN, outlines the duration of breastfeeding and support from health services to improve infant feeding practices amon ... g mothers living with HIV. It is intended to be used to complement emergency and sectoral guidelines on health, nutrition and HIV, including specifically infant feeding, prevention of mother-to-child transmission of HIV and paediatric antiretroviral treatment. more
This operational guidance, developed by WHO, UNICEF and ENN, outlines the duration of breastfeeding and support from health services to improve infant feeding practices amon ... g mothers living with HIV. It is intended to be used to complement emergency and sectoral guidelines on health, nutrition and HIV, including specifically infant feeding, prevention of mother-to-child transmission of HIV and paediatric antiretroviral treatment. more
The drugs issue cuts across the 2030 Agenda for Sustainable Development and multiple Sustainable Development Goals, including ending poverty, reducing inequalities, and, of course, improving health, with its targets on drug use, HIV, and other commu
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nicable diseases. Goal 16 on peace, justice, and strong institutions is particularly important, requiring attention to human rights across the Sustainable Development Goals. Since the late 1990s, United Nations (UN) General Assembly resolutions have acknowledged that ‘countering the world drug problem’ must be carried out ‘in full conformity’ with ‘all human rights and fundamental freedoms’.1 This has been reaffirmed in every major UN political declaration on drug control since, and in multiple resolutions adopted by the Commission on Narcotic Drugs.2 The reality, however, has not always lived up to this important commitment.
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This policy brief describes key HIV viral load thresholds and the available viral load testing approaches for monitoring how well antiretroviral therapy is working for people living with HIV. It pro
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vides clarification for and elaborates upon the current treatment monitoring algorithm from the Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach.
This information can help people living with HIV to live healthy lives, ensure that HIV is not transmitted to other people and support policy-makers in determining the optimal allocation of resources for viral load testing and communicating the results.
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This joint publication by UNAIDS and WHO emphasizes the importance of integrating HIV prevention, testing, treatment and care and mental health services for people living with HIV. It provides a com
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pilation of tools, best practices, recommendations and guidelines that facilitate the integration of interventions and services to address the interlinked issues of mental health and HIV. This publication is intended for global, regional and national policy-makers; programme implementers including at subnational levels; organizations working in and providers of HIV and mental health services; civil society; and community-based and community-led organizations and advocates.
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Global update on HIV treatment 2013: Results, impact and opportunities
World Health Organization; UNICEF; UNAIDS
(2013)
Chapter 1 provides new data on the latest developments in the global treatment effort, highlighting positive trends as well as aspects that require improvement. Chapter 2 summarizes the impact of the scale-up in reducing AIDS-related mortality and new HIV
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infections. Chapter 3 examines the sequence of steps in the continuum of care from HIV diagnosis to successful provision of ART services and outlines key supportive innovations. Chapter 4 discusses the implications and anticipated impact of the new "Consolidated guidelines on the use of ARV drugs for treating and preventing HIV infection
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Language influences the way we think, how we perceive reality, and how we behave. With respect to HIV, language can embody stigma and discrimination, which impacts access to testing, acquisition of HIV
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, and engagement with treatment. Language plays a role in supporting respect and empowerment of individuals, as communities shape how they are referred to and the labels they wish to use. Consideration and use of appropriate language can strengthen the global response to the HIV pandemic by diminishing stigma and discrimination and increasing support and understanding for individuals and communities living with HIV. Comments and suggestions for modifications should be sent to
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National Guidelines on Nutrition, Care, Support, and Treatment (NCST) for Adolescents and Adults
These guidelines are intended to:
• Establish a consistent set of nutrition interventions and r
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ecommendations aimed at managing and preventing undernutrition and overnutrition in adolescents and adults, with a focus on people with HIV/AIDS and tuberculosis (TB) patients.
• Provide simple and clear guidance to service providers and managers on how to implement the nutrition interventions and recommendations at the various health care delivery contact points.
• Provide a framework for policymakers and development partners to use when planning nutrition interventions for adolescent and adults.
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Latent Tuberculosis Infection : Updated and consolidated guidelines for programmatic management
recommended
The consolidated guidelines are expected to provide the basis and rationale for the development of national guidelines for LTBI management, adapted to the national and local epidemiology of TB, the
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availability of resources, the health infrastructure and other national and local determinants. The guidelines are to be used primarily in national TB and HIV control programmes, or their equivalents in ministries of health, and for other policy-makers working on TB and HIV and infectious diseases. They are also appropriate for officials in other line ministries with work in the areas of health.
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