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 provides clarification for and elaborates upon the current treatment monitoring algorithm from the Consol
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idated 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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The 2014–2015 Ebola outbreak was catastrophic in West Africa but the indirect impact of increasing the mortality rates of other conditions was also substantial. The increased number
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of deaths caused by malaria, HIV/AIDS, and tuberculosis attributable to health system failures exceeded deaths from Ebola.
With a relatively limited COVID-19 caseload, health systems may have the capacity to maintain routine service delivery in addition to managing COVID-19 cases. When caseloads are high, and/or health workers are directly affected, strategic adaptations are required to ensure that increasingly limited resources provide maximum benefit for the refugees and surrounding host population. The following are key considerations for UNHCR operations on prioritized health care services in the event of a COVID-19 outbreak. These are based on WHO Guidance for Maintaining Essential Health Services and UNHCR guidance for operations and where relevant operation or site level outbreak preparedness and response plans.
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The purpose of the Participant’s Workbook is to develop the skills and knowledge of personnel involved in wheelchair service
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delivery. The Participant’s Workbook contains exercises which will help to test and develop participants’ knowledge and skills. The Participant’s Workbook contains material from lectures, slide presentations and the reference manual; it is intended that the participants will keep their copy of the workbook for future reference, if needed.
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COVID-19 pandemic has become one of the biggest hindering threats to education service delivery worldwide which requires innovative solutions to ov
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ercome this situation and deliver education services to children. This pandemic has put the country in an emergency state compiled with the ongoing conflicts and return of refugees from neighboring countries such as Pakistan and Iran whom are suffering from this pandemic in great numbers and its estimated that many returning Afghan refugees will be affected by this virus that requires immediate attention.
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This discussion guide is designed to assist individuals and
agencies working toward developing trauma-informed
approaches to service delivery. It describes how common
traumatic experiences are fo
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r individuals accessing health
and social services, and it provides information to help service
providers recognize the adaptations people make to cope with
trauma. Trauma awareness is a foundation for developing
trauma-informed services, which integrate knowledge about
trauma into policies, procedures, and practices. Traumainformed
services actively seek to avoid re-traumatization and
have been shown to improve client engagement, retention, and
outcomes. This guide includes practice examples, suggested
resources, and sample questions to stimulate further discussion.
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Nepal has performed exceptionally in improving reproductive, maternal and child health outcomes over the past two decades. In this article, we discuss these achievements and outline a vision for the future of maternal, newborn and child survival in
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Nepal after the era of the Millennium Development Goals. On the pathway towards quality universal health care services for all, we propose strengthening of health information systems, gradual health system reforms, improvement of existing facility based services, development of integrated service delivery models, improved technical and managerial capacity at district and facility levels. Elimination of all preventable causes of maternal, newborn and child deaths in Nepal should be our collective aspirational goal.
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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
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.
• 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.
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The main finding is that health services have been partially or completely disrupted in many countries. More than half (53%) of the countries surveyed have partially or completely disrupted services for hypertension treatment; 49% for treatment for
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diabetes and diabetes-related complications; 42% for cancer treatment, and 31% for cardiovascular emergencies.
Rehabilitation services have been disrupted in almost two-thirds (63%) of countries, even though rehabilitation is key to a healthy recovery following severe illness from COVID-19.
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Background
Low- and middle-income countries now experience the highest prevalence and mortality rates of cardiovascular disease.
Main text
While improving the availability and delivery
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of proven, effective therapies will no doubt mitigate this burden, we posit that studies evaluating cardiovascular disease risk factors, management strategies and service delivery, in diverse settings and diverse populations, are equally critical to improving outcomes in low- and middle-income countries. Focusing on examples drawn from four cardiovascular diseases — coronary artery disease, stroke, diabetes and kidney disease — we argue that ethnicity, culture and context matter in determining the risk factors for disease as well as the comparative effectiveness of medications and other interventions, particularly diet and lifestyle interventions.
Conclusion
We believe that a host of cohort studies and randomized control trials currently being conducted or planned in low- and middle-income countries, focusing on previously understudied race/ethnic groups, have the potential to increase knowledge about the cause(s) and management of cardiovascular diseases across the world.
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this Service Delivery brief provides evidence-based strategies that can help support drug shops and pharmacies in providing a wider variety of fami
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ly planning methods and information. Evidence shows that with training and support, pharmacy and drug shop staff can facilitate the use of a broad range of modern contraception, especially in areas where the unmet need is high, access to family planning services is poor, and health worker shortages and other barriers prevent women, men, and youth from accessing family planning services
Availabe in English, French, Spanish and Portuguese
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The Department of Health is committed to providing the best quality care to patients and users of health services, in order to meet their expectations and needs, and to improve
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service delivery.
The main purpose of the National Core Standards is to:
• Develop a common definition of quality of care, which should be found in all health establishments in South Africa as a guide to the public and to managers and staff at all levels;
• Establish a benchmark against which health establishments can be assessed, gaps identified, strengths appraised; and
• Provide a national framework to certify health establishments as compliant with standards
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For IST to be effective there is need for utilization of multiple techniques that will lead to transfer of competences (Bluestone et al. 2013). Learning settings should be selected to support releva
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nt and realistic practice so as to increase the efficiency of IST. Alternatives to hotels such as training institutions and hospitals are viable options for reducing costs of IST as well as being appropriate venues (MOH 2012). There is documented evidence of involvement of academic institutions in providing health leadership capacity building through IST in other countries; for example, in Uganda, IST in leadership for doctors and nurses was done through a blended approach that included didactic and online sessions (Nakanjako et al. 2015). Adapting these concepts, FUNZOKenya piloted eight regional hubs, each serving a cluster of counties, which would train health workers for five years (2012-2016) on priority service delivery topics
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Q 6. Does the provision of sterile injection equipment to injecting drug users reduce injecting related harm? Is advice on ways to reduce drug related harm safe and effective, using an outreach model of
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service delivery?
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Malawi’s first National Community Health Strategy (NCHS, 2017-2022) defines a new community health system in which community health cadres, both formal and non-formal, deliver services of the Essential Health Package, with a focus on child and mat
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ernal health. It envisages an integrated approach to service delivery and is embedded in Malawi’s Health Sector Strategic Plan (HSSPII).
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AHRO Reviews of Nursing is an international open-access journal that promotes the dissemination of quality knowledge in all aspects of nursing pra
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ctice
The AHRO Review of Nursing (ARN) is an international, open-access, peer reviewed, scientific journal that seeks to promote the dissemination of quality knowledge related to all spheres of nursing practice. The primary aim is to promote a high standard of clinically related scholarship which advances and supports the practice and discipline of nursing. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, ARN seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Emphasis is placed on promoting critical debate on the art and science of nursing practice.
ARN is essential reading for anyone involved in nursing practice, whether clinicians, researchers, educators, managers, policy makers, or students. The development of clinical practice and the changing patterns of inter-professional working are also central to ARN's scope of interest. Contributions are welcomed from other health professionals on issues that have a direct impact on nursing practice.
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This course aims to provide information on the basic understanding of palliative care and the elements of service program for delivering palliative
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care. The course contents will also include the considerations in managing signs, symptoms and assessing the patient as well as communicating with the patient, family, and care giver, and the principles and management of respiratory, gastrointestinal, urogenital, nervous systems’ symptoms and conditions in palliative care.
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Background
The ambitious development agenda of the Sustainable Development Goals (SDGs) requires substantial investments across several sectors, including for SDG 3 (healthy lives and wellbeing). No estimates
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of the additional resources needed to strengthen comprehensive health service delivery towards the attainment of SDG 3 and universal health coverage in low-income and middle-income countries have been published.
Methods
We developed a framework for health systems strengthening, within which population-level and individual-level health service coverage is gradually scaled up over time. We developed projections for 67 low-income and middle-income countries from 2016 to 2030, representing 95% of the total population in low-income and middle-income countries. We considered four service delivery platforms, and modelled two scenarios with differing levels of ambition: a progress scenario, in which countries’ advancement towards global targets is constrained by their health system’s assumed absorptive capacity, and an ambitious scenario, in which most countries attain the global targets. We estimated the associated costs and health effects, including reduced prevalence of illness, lives saved, and increases in life expectancy. We projected available funding by country and year, taking into account economic growth and anticipated allocation towards the health sector, to allow for an analysis of affordability and financial sustainability.
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