A supplement to The State of the World’s Children Report 2009
The coronavirus outbreak that began in 2019 (COVID-19) threatens to reverse years of hard-won gains in preventing and treating HIV. Fragile ...lass="attribute-to-highlight medbox">health systems are further stressed as health workers navigate an increased client load and demands at work while also being concerned for their own health and that of their families. Health facilities have been redesigned to care for patients with COVID-19, posing challenges to other services. Governments and civil society organizations have redirected scarce resources and shifted programming priorities to respond to the pandemic. Several countries have reported intermittent declines in HIV testing and diagnosis, antenatal care visits, collection of antiretroviral medicines (ARVs) by people living with HIV, and attendance at clinic appointments. Community-based education and support programmes have had to rapidly adapt to restrictions on movement and public gatherings. Children, adolescents, and women have experienced multiple deprivations due to the adverse impact of the pandemic.
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Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in d...isease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expanding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
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This document was conducted as a desk study and provides useful information and practical examples of responses to ...ght medbox">HIV and AIDS in the fields of agriculture, rural development, self-help and social protection. It aims to invite Misereor partners and others working in these fields to reflect on their current approaches and to encourage them to respond, in their core business, to the challenges presented by HIV and AIDS.
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The goal of the United States Government for the President's Emergency Plan for AIDS Relief (PEPFAR) in Mozambique is to support country efforts to achieve epidemic control by 2020 through evidence...-based policies and interventions to drive progress and save
lives. This document details PEPFAR's operational plan in Mozambique.
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Over the reporting period, THP-Burkina Faso (THP-Burkina) maintained a continuous focus on ensuring the selfreliance of the health program in each of...n> its epicenters. Building upon its exclusive use of government-run health clinics at its epicenters, THP-Burkina developed a firstever partnership agreement with the national Ministry of Health. This allowed greater partnership with medical professionals at the epicenter level, as was practiced at Boulkon Epicenter in June 2012 (see photo). THPBurkina continued advancing four of its 10 Phase III epicenter rural banks toward government recognition.
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