While there has been real progress in addressing the burden of disease in the WHO African region, the COVID-19 pandemic has highlighted the link between health, economics ...ighlight medbox">and security, as the region saw decades of progress threatened, including positive trends in decreasing inequality. In the African Region the momentum towards achieving the 2030 SDG disease burden reduction targets (SDG targets 3.3, 3.4 and 3B) has stalled.
The COVID-19 pandemic was also a major threat to gains made, such as the eradication of polio in the region, declared in 2020; reduced numbers of new HIV infections in 2021 compared to 2010; and passing the 2020 milestone of the End TB Strategy, with a 22% reduction in new cases compared with 2015. However, the pandemic also disrupted essential health services in 92% of countries globally, 22.7 million children missed basic immunization, there was an increase in malaria and TB, and global deaths from TB rose for the first time since 2015.
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The consolidated guidelines are expected to provide the basis and rationale for the development of national guidelines for LTBI management, adapted to the national ...t medbox">and local epidemiology of TB, the availability of resources, the health infrastructure and other national and local determinants. The guidelines are to be used primarily in national TB and HIV control programmes, or their equivalents in ministries of health, and for other policy-makers working on TB and HIV and infectious diseases. They are also appropriate for officials in other line ministries with work in the areas of health.
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Background: Cervical cancer accounts for 23% of cancer incidence and 22% of cancer mortality among women in Burkina Faso. These proportions are mor...e than 2 and 5 times higher than those of developed countries, respectively. Before 2010, cervical cancer prevention (CECAP) services in Burkina Faso were limited to temporary screening campaigns.
Program Description: Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity.
Methods: Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy.
Results: Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day started at a high of 82% to 93% when services were provided free of charge, but dropped to 51% when a user fee of $10 was applied to cover the cost of supplies. After reducing the fee to $4 in November 2012, the proportion increased again to 78%. Implementation challenges included difficulties tracking referred patients, stock-outs of key supplies, difficulties with machine maintenance, and prohibitive user fees. Providers were trained to independently monitor services, identify gaps, and take corrective actions.
Conclusions: Following dissemination of the results that demonstrated the acceptability and feasibility of the CECAP program, the Burkina Faso Ministry of Health included CECAP services in its minimum service delivery package in 2016. Essential components for such programs include provider training on VIA, cryotherapy, and LEEP; provider and patient demand generation; local equipment maintenance; consistent supply stocks; referral system for LEEP; non-prohibitive fees; and a monitoring data collection system.
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The review’s objectives are to review progress in TB control with emphasis on DOTS strategy implementation, summarize the experience, lessons learnt and methods of work ...ighlight medbox">and to make recommendations for international donors, technical agencies and the Ministry of Health.
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Outstanding child and adolescent TB priorities include the need to: find the missing children with active TB and link them to TB care; prevent TB in children who are in contact with infectious TB ca...ses (through implementation of active contact investigation and provision of preventive treatment); and advance integration within general child health services, including maternal and child health/ reproductive, maternal, newborn, child and adolescent health, HIV, nutrition and other programmes.
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Recommendations for a public health approach
2010 revision
Supplement
HIV testing services
December 2016
2014-2020, Draft March 2014
Circumcision – consultative review of additional information, 12 August 2016
21 September 2016
Policy and Legal Opportunities for HIV Testing Services and Civil Society Engagement
Third Stocktaking Report, 2008
Unite for Children, Unite against AIDS