Supplement Article
J Acquir Immune Defic Syndr Volume 78, Supplement 1, August 15, 2018 www.jaids.com
Vreeman RC et al. Journal of the International AIDS Society 2017, 20(Suppl 3):21497 http://www.jiasociety.org/index.php/jias/article/view/21497 | http://dx.doi.org/10.7448/IAS.20.4.21497
Depuis plus de trois décennies, le Bénin a souscrit à l’approche des soins de santé primaires
telle que définie à la conférence d’Alma-Ata (1978) et renforcée par l’Initiative de Bamako
(1987). Le pays a mis en oeuvre diverses expériences de soins de santé au niveau
communautaire ...avec l’appui des Partenaires Techniques et Financiers (PTF) et la
participation des Organisations Non Gouvernementales (ONG) et les Organisations
Communautaires de Base (OCB). Celles-ci ont contribué à l’amélioration de l’offre des
services de santé, malgré l’absence d’une politique coordonnée devant servir de cadre
institutionnel à la santé communautaire.
A l’étape actuelle du processus de mise en oeuvre de diverses expériences pilotes d’actions
communautaires, le Ministère de la Santé s’est engagé dans une réflexion visant l’élaboration
d’une politique nationale de santé communautaire. Celle-ci devra servir à encadrer la mise à
l’échelle des interventions communautaires qui ont démontré leur efficacité et leur impact
sur les populations cibles. Cette réflexion a entraîné la tenue du forum national sur la santé
communautaire en Novembre 2013 à Cotonou.
Le document de Politique de Santé Communautaire s’arrime au Plan National de
Développement Sanitaire à travers lequel le Bénin ambitionne de « disposer en 2025 d’un
système de santé performant basé sur des initiatives publiques et privées, individuelles et
collectives, pour l’offre et la disponibilité permanente de soins de qualité, équitable et
accessible aux populations de toutes catégories, fondées sur les valeurs de solidarité et de
partage du risque pour répondre à l’ensemble des besoins de santé du peuple béninois » Dans
le présent document, il est défini une vision, des priorités et des stratégies pour les dix
prochaines années en santé communautaire. La principale innovation réside dans la
conception et la mise en place au niveau de chaque village et quartier de ville de la
composante locale du système national de santé (CoLoSS) en partenariat avec toutes les
parties prenantes. Le document précise les conditions requises et les mesures
d’accompagnement pour la réussite de la nouvelle politique dans le sens de l’autonomisation
(empowerment) progressive des populations.
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Second Edition
Good Policy and Practice in HIV & AIDS and Education
The GHS Index is intended to be a key resource in the face of increasing risks of high-consequence and globally catastrophic biological events and in light of major gaps in international financing for preparedness. These risks are magnified by a rapidly changing and interconnected world; increasing ...political instability; urbanization; climate change; and rapid technology advances that make it easier, cheaper, and faster to create and engineer pathogens.
Key findings from the study of 195 countries:
• Out of a possible 100 points, the average GHS Index score across 195 countries was 40.2.
• The majority of high- and middle-income countries do not score above 50.
• Action is urgently needed to improve countries’ readiness for high-consequence infectious disease outbreaks.
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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.
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The government of Kazakhstan has committed to ensuring that children with disabilities have access to inclusive education and it has taken the important step of ratifying international human rights treaties enshrining the rights of people with disabilities, including the right of children with disab...ilities to inclusive, quality education. The government has also introduced legal and policy changes toward an inclusive education system for children with disabilities. It has committed to ensuring that 70 percent of mainstream schools are inclusive by 2019.
However, this report finds that progress towards genuine inclusive education is slow. In order for the government to succeed in ensuring that all children can access an inclusive, quality, and free primary and secondary education on an equal basis with others in the communities in which they live, it will need to fundamentally transform its policies and approach to education and address negative attitudes more broadly towards people with disabilities in Kazakhstan.
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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.
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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.
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The report discusses the epidemiological and social aspects of ageing, health and functional changes experienced with ageing, the impact of physical activity, assessment of the nutritional status of older persons, and nutritional guidelines for healthy ageing.
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.
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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...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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Monitoring is a crucial element in any successful programme. It is important to
know if health care facilities – and ultimately countries – are meeting the agreed
goals and objectives for preventing and managing cardiovascular diseases (CVD).
Monitoring is the on-going collection, management ...and use of information to
assess whether an activity or programme is proceeding according to plan and/
or achieving defined targets. Not all outcomes of interest can be monitored. Clear
outcomes must be identified that relate to the most important changes expected to result from the project and to what is realistic and measurable within the timescale of the project. Once these outcomes have been articulated, indicators can be chosen that best measure whether the desired outcomes are being met.
To allow progress to be monitored, this module provides a set of indicators on
CVD management. Agreeing on a set of indicators allows countries to compare
progress in CVD management and treatment across different districts or
subnational jurisdictions, as well as at a facility level, identify where performance
can be improved, and track trends in implementation over time. Monitoring
these indicators also helps identify problems that may be encountered so that
implementation efforts can be redirected.
This module starts from the collection of data at facility level, which is then
“transferred up” the system: facility-level data are aggregated at subnational level
to produce reports that allow tracking of facility and subnational performance over time and allow for comparison among facilities. National-level data are obtained through population-based surveys.
Implementing a monitoring system requires action at many levels. At national and
subnational levels, staff can determine how best to integrate data elements into
existing data collection systems – such as the routine service-delivery data that are collected through facility-level Health Management Information Systems (HMIS).
In the facility setting, personnel must be aware of what data are needed. Sample
data-collection tools are included, recognizing that countries use different datamanagement systems for HMIS, so the CVD monitoring tools will be adapted to work with the HMIS system being used by the country, such that the indicators can be collected with minimal disruption/work to existing systems and tools
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Anema et al. AIDS Research and Therapy 2011, 8:13 http://www.aidsrestherapy.com/content/8/1/13
The Open AIDS Journal, 2012, 6, 245-258
A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association
AHA/ASA Guideline
DOI: 10.1161/STR.0000000000000158