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1
A Global Research Agenda for Adolescents Living With HIV
A. Armstrong; J. M. Nagata; M. Vicari; et al.
Journal of Acquired Immune Deficiency Syndromes (JAIDS ); Ovid
(2018)
CC
Supplement Article
J Acquir Immune Defic Syndr Volume 78, Supplement 1, August 15, 2018 www.jaids.com
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.
more
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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Many low-resource settings have a shortage of physicians and health workers. (1) In order to provide patient-centred continuous care more effectively, primary care systems can include team-based care strategies in their clinic workflows and protocols. Team-based care uses multidisciplinary teams (wh
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ich may involve new staff, or the shifting of tasks among existing staff). Teams can include patients themselves, primary care physicians, and other allied health professionals, such as nurses, pharmacists, counsellors, social workers, nutritionists, community health workers, or others. Teams reduce the burden on physicians by utilizing the skills of trained health workers. Strong evidence shows that team-based care is effective in improving hypertension control among patients in a cost-effective way. (2) Some amount of task shifting/team-based care is already taking place in many settings; this module provides further guidance on how to maximize this approach for greater impact.
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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
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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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Реализация комплексных программ по профилактике ВИЧ/ИППП среди секс-работников: ПРактИЧескИе Подходы на осноВе соВместных меРоПРИятИй
Всемирная организация здравоохранения (World Health Organization); UNFPA; UNAIDS; et al.
(2015)
C_WHO
HIV and young people who sell sex
UNAIDS, UNODC (United Nations Office on Drugs and Crime); World Health Organization; MSMGF; et al.
(2015)
C_WHO
Technical Brief
Prevention and Treatment of HIV ands other sexually transmitted infections among men who have sex with men and transgender people
World Health Organization; UNAIDS; UNDP; et al.
(2011)
C_WHO
Recommendations for a public health approach
HIV/AIDS Programme
HIV and young transgender people
World; UNFPA; UNHCR (The UN Refugee Agency); et al.
(2015)
C_WHO
Technical Brief
HIV and young men who have sex with men
World Health Organization; UNFPA; UNAIDS; etc al.
(2015)
C_WHO
Technical Brief
Damon Barrett, Gonçalo Figueiredo Augusto, Martiani Oktavia, Jeanette Olsson, Mira Schneiders and Kate Welch provided background papers and literature reviews which informed this technical series.
HIV and young people who inject drugs
A. Armstrong; J. Baer; R. Baggaley; et al.
UNAIDS; World Health Organization; UNFPA; et al.
(2015)
C_WHO
Technical Brief
Serving the needs of Key Populations: Case examples of innovation and good practice in HIV Prevention, Diagnosis, Treatment and Care
A. Armstrong; C. Irvine; C. Figueroa; A. Verster; R. Baggaley et al.
World Health Organization
(2017)
C_WHO
Key Populations
HIV/AIDS prevention and care among armed forces and UN peacekeepers: The Case of Eritrea
T. Nakari; D. Mathiot; G. Lescornec; et al.
UNAIDS (Joint United Nations Programme on HIVAIDS); African Union; H6 Partnership; Unicef; UNDP; et al.
(2003)
C2
UNAIDS Series: Engaging uniformed services in the fight against AIDS - Case Study 1
Fighting AIDS
USAID Office of HIV/AIDS
March 8-9, 2016
Public health guidance on HIV, hepatitis B and C testing in the EU/EEA - An integrated approach
A.Sullivan; A. van Ahee; C. Rae; et al.
European Centre for Disease Prevention and Control
(2018)
C2
Scientific Advice
Act Toolkit 2.0 - Advocacy for community Treatment
B. Killingo; T. Taro; E. Whyle; et al.
ITPC (International Treatment Preparedness Coalition)
(2016)
C2
Strengthening Community responses to HIv Treatment and Prevention
Unite for Children
First Edition
April 2013
Policy
Brief
In September, 2018, the first international Medicine Quality and Public Health Conference was held at Oxford University, UK, to discuss opportunities and solutions to ensure that all people have access to affordable and quality-assured medical products. Delegates developed the short Oxford Statement
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, calling for investment, policy change, and action to eliminate substandard and falsified medical products. The statement was born out of discussion between governments, national and international agencies, non-governmental organisations, professional associations, and academic institutions who together examined the latest evidence on the epidemiology and public health implications of substandard and falsified medical products.
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