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Journal of the International AIDS Society 2017, 20(Suppl 4):21644
National AIDS Programme in Myanmar has made significant progress in scaling up antiretroviral treatment (ART) services and recognizes the importance of differentiated care for people living ... with HIV. Indeed, long centred around the hospital and reliant on physicians, the country's HIV response is undergoing a process of successful decentralization with HIV care increasingly being integrated into other health services as part of a systematic effort to expand access to HIV treatment. This study describes implementation of differentiated care in Médecins Sans Frontières (MSF)‐supported programmes and reports its outcomes.
https://doi.org/10.7448/IAS.20.5.21644 more
National AIDS Programme in Myanmar has made significant progress in scaling up antiretroviral treatment (ART) services and recognizes the importance of differentiated care for people living ... with HIV. Indeed, long centred around the hospital and reliant on physicians, the country's HIV response is undergoing a process of successful decentralization with HIV care increasingly being integrated into other health services as part of a systematic effort to expand access to HIV treatment. This study describes implementation of differentiated care in Médecins Sans Frontières (MSF)‐supported programmes and reports its outcomes.
https://doi.org/10.7448/IAS.20.5.21644 more
‘Psychosocial Support of Children in Emergencies’ is a reference document for humanitarian workers who want to increase their understanding of the experiences of children in emergency situations
...
and how to support them in mitigating the negative effects of these experiences and how to prevent further harm. While the book is not designed to be a day-to-day programming tool, it outlines UNICEF’s orientation to the psychosocial principles integral to any work with children and provides a number of examples from field work of how these principles can be turned into concrete actions.
more
This report presents the most current data on four specific forms of violence – violent discipline and exposure to domestic abuse during early childhood; violence at school; violent deaths among adolescents; and sexual violence in childhood and adolescence. The statistics reveal that
...
children experience violence across all stages of childhood, in diverse settings, and often at the hands of the trusted individuals with whom they interact daily. The report concludes with specific national actions and strategies that UNICEF has embraced to prevent and respond to violence against children.
more
The Burden of Breadwinning: Transformative Masculinities in the Context of HIV, Violence against Women and Gender Inequality
Brot für die Welt
(2016)
C2
Since the Fourth World Conference on Women in Beijing in 1995, gender mainstreaming has become a widespread strategy for changing unequal social and institutional structures which discriminate against women and girls, with the goal of achieving gend
...
er equality. Much has changed for women since 1995: they have become more visible as actors in society, economy and politics. Public awareness regarding their discrimination has increased. However, most societies remain based on patriarchy and male hegemony. Patriarchal structures and institutions cannot easily be changed and the struggle for gender equality is still far from being won.
more
MSF provides treatment for HIV and tuberculosis (TB) in more than 20 countries around the world. The report Burden sharing or burden shifting? How the HIV/TB response is being derailed examines the
...
situation in nine countries where MSF runs programmes: Central African Republic, Democratic Republic of Congo, Eswatini, Guinea, Kenya, Malawi, Mozambique, Myanmar and Zimbabwe. With a focus on the financial resources available, this report highlights the current risks and gaps in HIV and TB service delivery in these countries.
Given the findings of gaps in diagnosis, prevention and care services and dwindling resources, MSF calls for a robust assessment of the needs and the resource capacity of each affected country, and calls on international donors to ensure that the financial burden is shared, rather than shifted onto those countries worst affected by the diseases.
more
Masangane Case Study
The Vesper Society commissioned ARHAP to do research on the integrated Masangane HIV/AIDS programme affiliated with the Moravian Church in Eastern Cape, South Africa. Completed
...
in 2006, this study aimed to understand the role of the religious health assets of the Masangane ART programme for public health, as a model for a replicable response to HIV/AIDS. A crucial aspect of this research involved teasing out what value is added to this programme by its faith-based nature. Field work for this case study consisted of more than 20 key informant interviews of various stakeholders: Masangane staff and management; church leaders; health seekers; donors and health providers. Health seekers also answered 77 questionnaires and were involved in two focus groups.
more
In 2020, the COVID-19 pandemic impacted the world beyond imagination. To date, it has infected more than 135 million people, killed over 2.9 million people, and is projected to plunge up to 115 million people into extreme poverty.1 As countries have gone into lockdown, gender-based violence has incr
...
eased, unemployment has soared, and access to health care for the poorest and most vulnerable has been cut. COVID-19 has made people less likely to seek health care because they are afraid of getting infected with the virus. Fear and uncertainty surrounding COVID-19 have also increased stigma and discrimination. As frontline workers without enough access to personal protective equipment (PPE) risk their lives to treat patients, the virus pushes already fragile health systems to the brink.
more
Joint actions by the Global Fund and UNAIDS are guided by a strong alignment of strategies, goals and targets. UNAIDS has worked with all stakeholders to set a common agenda and targets within the Global AIDS Strategy 2021–2026, and the United Nat
...
ions General Assembly confirmed this strategy and its ambitious targets within its 2021 Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030.
more
Adolescence, defined as the period between 10 and 19 years of age, is a developmental stage during which many psychosocial and mental health challenges emerge. There is a well-established link between mental health and HIV outcomes. Adolescents and
...
young adults living with HIV typically have additional mental health needs linked to their experiences of living with and managing a chronic illness, along with prevailing stigma and discrimination. Mental health promotion and prevention is thus a critical priority for this group.
more
The 2030 health-related Sustainable Development Goals call on countries to end AIDS as a public health threat and also to achieve universal health coverage. The World Health Organization (WHO) promotes primary health care (PHC) as the key mechanism for achieving universal health coverage, and the PH
...
C approach is also essential for ending AIDS and reaching other Sustainable Development Goal targets.
The PHC approach is defined as a whole-of-society approach to health that aims to maximize the level and distribution of health and well-being through three components: (1) primary care and essential public health functions as the core of integrated health services; (2) multisectoral policy and action; and (3) empowered people and communities.
This publication helps decision-makers to consider and optimize the synergies between existing and future assets and investments intended for both PHC and disease-specific responses, including HIV. Specifically, it aims to:
• provide guidance to policy-makers, health system managers and programmatic leads from both PHC and HIV backgrounds regarding opportunities to jointly advance their respective efforts to strengthen PHC and end AIDS as a public health threat; and
• provide a resource for all stakeholders who seek to contribute to strengthening PHC and ending AIDS as a public health threat in a synergistic manner, including people living with HIV, members of key and vulnerable populations, community and civil society representatives, people working in all areas of health systems, researchers, funders and private-sector decision-makers.
more
The Updated guidelines on Management of tuberculosis in children and adolescents include new recommendations that cover diagnostic approaches for TB, shorter treatment for children
...
with non-severe drug-susceptible TB, a new option for the treatment of TB meningitis, the use of bedaquiline and delamanid in young children with multidrug- and rifampicin-resistant TB and decentralized and family-centred, integrated models of care for TB case detection and prevention in children and adolescents.
more
The WHO Global strategy on human resources for health: workforce 2030 encourages development partners and global health initiatives to leverage their support to health systems in countries to sustainably strengthen the health workforce. To assess the impact of these investments, a methodology was de
...
veloped and pilot tested by WHO.
The impact assessment tool (consisting of an MS Excel calculator with two subsets) supports users to:
• assess and quantify the health impact of HRH investments made in the context of HIV, tuberculosis (TB) and malaria programmes through their modelled effect on health service coverage of these three diseases; and
• provide aggregate indicative estimates of the range of health workers required to attain high coverage of selected health services.
more
Background
Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We condu
...
cted a randomised controlled trial of an enhanced asthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.
Methods
We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified.
Results
Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach.
Discussion
Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.
more
This Rapid Advice Guideline updates the Interim Guidance on the “Assessment of infants with microcephaly in the context of Zika virus” published in February 2016 (WHO/ZIKV/MOC/16.3). The recommendations provides guidance on the screening, clinic
...
al assessment, neuroimaging, laboratory investigation and follow-up of children born to women living in areas of Zika virus transmission. The Guideline summarises the evidence base and rationale in support of the recommendations and expands the scope to address complications beyond microcephaly and what is now referred to as the congenital Zika virus syndrome
more
The article is a scoping review that explores the challenges in diagnosing asthma in children in three sub-Saharan African countries: Nigeria, South Africa, and Uganda. It identifies key barriers, such as a lack of community awareness, inadequate he
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althcare access, limited diagnostic tools like spirometry, and insufficient knowledge among healthcare workers. The review also highlights the stigma associated with asthma and the absence of relevant diagnostic guidelines. Solutions proposed include community education, development and adherence to diagnostic guidelines, and strengthening healthcare systems. The study aims to inform policymakers and healthcare providers to improve asthma diagnosis and care for children in these regions.
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This document provides interim guidance to countries on testing considerations and strategies for suspect cases of severe acute hepatitis of unknown aetiology in children. It is primarily intended for clinical, programmatic, laboratory and diagnosti
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c stakeholders across Member States and national public health authorities involved in the identification and investigation of cases of severe acute hepatitis in children.
This document is part of a package of guidance for this event, which includes suggested minimum reporting variables and a clinical Case Report Form support Member States with case investigation and reporting.
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This document was prepared in response to a need to review and potentially update the current recommendations for the antibiotic treatment of both inpatient and outpatient management of severe acute malnutrition (SAM). The current recommendations (Table 1) are based on guidelines published in 2013 i
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n the WHO Pocketbook for Hospital Care for Children, and the 2013 update on SAM (outpatient management). The global threat of increasing antimicrobial resistance and new data on efficacy and safety profiles requires a re-review of the current evidence to ensure recommendations are the most appropriate. The evidence base for the use of antibiotics in children presenting with uncomplicated SAM has been recently enlarged.
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WHO operational handbook on tuberculosis Module 5: Management of tuberculosis in children and adolescents
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The practical guidance in the operational handbook aims to inform the development or revision of national policies and related implementation guidance on the management of TB in children and adolescents under programmatic circumstances and at differ
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ent levels of the health system. The operational handbook can also help countries adequately plan for the uptake of interventions to better address the specific needs of children and adolescents with or at risk of TB. It can contribute to national efforts to build capacity among national and subnational programme managers and among health workers at all levels of the health care system.
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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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Asthma is the most common chronic condition in children worldwide. It affects daytime activities, sleep and school attendance and causes anxiety to parents, families and other carers. The quality of asthma diagnosis and management globally still nee
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ds substantial improvement. From infancy to the teenage years, there are age-specific challenges, including both underdiagnosis and overdiagnosis with stigma-related barriers to treatment in some cultures and in adolescents. The Paediatric Asthma Project Plan has been initiated to strengthen diagnosis and management of asthma. This encompasses a vision for the next 10–15 years, building on the knowledge and experience from previous educational projects. It will take into account the educational needs of patients, carers and healthcare professionals as well as the accessibility and affordability of medication, particularly in low and middle-income countries where the prevalence of asthma is rising more rapidly. This overview presents a first step for those involved in the diagnosis and management of childhood asthma to strengthen care for children globally.
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