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Despite progress in improving antiretroviral therapy (ART) for people with HIV in Malawi, the burden of HIV infections and HIV treatment outcomes among key ...opulations is suboptimal. Client-centered differentiated service delivery approaches may facilitate addressing HIV prevention and treatment needs of key populations in Malawi.
Methods
De-identified program data routinely collected as part of the LINKAGES project–Malawi were assembled from October 2017 to September 2019. HIV case finding was compared across different testing modalities for each population. Poisson regression was used to estimate the association between testing modalities and ART initiation.
Results
Of the 18 397 people included in analyses, 10 627 (58%) were female sex workers (FSWs), 2219 (12%) were men who have sex with men (MSM), and 4970 (27%) were clients of FSWs. HIV case finding varied by modality and population, with index testing and enhanced peer outreach demonstrating high yield despite reaching relatively few individuals. FSWs who tested positive through risk network referral testing were more likely to initiate ART within 30 days compared with those who tested positive through clinic-based testing (adjusted risk ratio [aRR], 1.50; 95% CI, 1.23–1.82). For MSM, index testing (aRR, 1.45; 95% CI, 1.06–2.00) and testing through a drop-in center (aRR, 1.82; 95% CI, 1.19–2.78) were associated with 30-day ART initiation.
Conclusions
These data suggest that differentiated HIV testing and outreach approaches tailored to the needs of different key populations may facilitate improved ART initiation in Malawi. Achieving 0 new infections by 2030 suggests the need to adapt treatment strategies given individual and structural barriers to treatment for key populations with HIV in high-prevalence settings.
BMJ Global Health2020;5:e002786. doi:10.1136/bmjgh-2020-002786
People with disabilities experience significant health inequalities. In Malawi, where most individuals live in low-income rural settings, many of these inequalities are exacerbated by restricted access to health care services. This qualitative study...
O Fórum de Monitoria do Orçamento - FMO, em colaboração com o Ministério da Economia e Finanças (MEF) e o Fundo das Nações Unidas para a Infância (UNICEF), decidiu elaborar a presente Broch...
O que as crianças devem saber sobre a esquistossomose - Banda desenhada
AGRADECIMENTO: Este documento foi produzido com o apoio financeiro da Merck Alemanha. Em 2007, a Merck estabeleceu uma ...arceria com a Organização Mundial da Saúde para combater a esquistossomose entre os estudantes no continente africano. Inicialmente, a Merck fará uma doação de 250 milhões de comprimidos de Cesol 600, que contém o princípio ativo praziquantel. A Merck pretende dar continuidade a esse compromisso para que essa enfermidade seja eliminada na África.
Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 111
The health services delivery system in Zambia is pyramid in structure, with ...rimary healthcare (PHC) services at community level, at the base, followed by first and second level hospitals at district and provincial levels, respectively, and third level (tertiary) services at national level. Notably, primary health services are free in Zambia and health service providers are either governmentowned or not-for-profit facilities.
Over the years, resource constraints have affected the quality and extent of healthcare services at all levels, requiring the mobilisation of additional resources for the sector. In doing so, prioritisation was high on the agenda of health sector reform. The EHB, therefore, prioritises interventions with the highest impact on the population, enabling policy makers to revisit priority diseases and conditions and to cost the services provided at each level of facility. Other key issues in developing the EHB in Zambia have included the need to have cost-effective services and cost per capita of services for more systematic budgeting, to rank interventions and to validate and cost the health benefit package as a whole.
The health services delivery system in Zambia is pyramid in structure, with ...rimary healthcare (PHC) services at community level, at the base, followed by first and second level hospitals at district and provincial levels, respectively, and third level (tertiary) services at national level. Notably, primary health services are free in Zambia and health service providers are either governmentowned or not-for-profit facilities.
Over the years, resource constraints have affected the quality and extent of healthcare services at all levels, requiring the mobilisation of additional resources for the sector. In doing so, prioritisation was high on the agenda of health sector reform. The EHB, therefore, prioritises interventions with the highest impact on the population, enabling policy makers to revisit priority diseases and conditions and to cost the services provided at each level of facility. Other key issues in developing the EHB in Zambia have included the need to have cost-effective services and cost per capita of services for more systematic budgeting, to rank interventions and to validate and cost the health benefit package as a whole.
A recent article published by NPR reporting how trusted faith leaders, in this case nuns, have a workable system to transmit health messages in local languages in Zambia. They have broadcast information on maternal & child health and COVID-19 on a C...
Mapping "Pro Poor" Policy in Aceh Province 2007-2011
Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based
primary health care through screening, trea...
Guide d'accompagnement de la formation en ligne.
Accessed March 2019
Large File: 17 MB
2nd edition.
Like the original, this second edition of the guidance aims to inform the revision of existing national guidelines and standards for managing Tuberculosis (TB), many of which include guidance on children. It includes recommendations, based on the best available evidence, for improving ...
Number of Community Health Centers as June 2014 by Province and City in Indonesia
