During the implementation of the National Strategic Plan 2009–2012 on HIV and AIDS, Rwanda has continued its progress towards universal
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access to HIV and AIDS services. The new HIV and AIDS National Strategic Plan July 2013–June 2018 (thereafter referred to as ‘the NSP’) presented here is set on pursuing the same objective, with inspiration from the global targets of “zero new HIV infections, zero HIV-related deaths and zero stigma and discrimination due to HIV”.
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Inequality of access to palliative care and symptom relief is one of the greatest disparities in
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global health care (1). Currently, there is avoidable suffering on a massive scale due to lack of access to palliative care and symptom relief in low- and middle-income countries (LMICs) (1). Yet basic palliative care that can prevent or relieve most suffering due to serious or life-threatening health conditions can be taught easily to generalist clinicians, can be provided in the community and requires only simple, inexpensive medicines and equipment. For these reasons, the World Health Assembly (WHA) resolved that palliative care is "an ethical responsibility of health systems"(2). Further, most patients who need palliative care are at home and prefer to remain there. Thus, it is imperative that palliative care be provided in the community as part of primary care. This document was written to assist ministries of health and health care planners, implementers and managers to integrate palliative care and symptom control into primary health care (PHC).
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In 2014, GHS/NACP, with support from UNICEF and other partners, conducted a situation analysis on paediatric HIV care
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and treatment in Ghana. The purpose of this analysis was to identify the gaps within the current delivery of paediatric HIV care and support system and develop a road map for effective implementation of Early Infant Diagnosis (EID) and to increase paediatric antiretroviral therapy (ART) coverage. The analysis identified gaps such as lack of task shifting on ART services, low paediatric ART coverage, and poor linkage of ART, EID, and PMTCT services with other RCH - immunization and nutrition services.
In view of the findings of the analysis, it was recommended that an Acceleration Plan for Paediatric HIV Services be developed to address the barriers and bottlenecks identified during the assessment. At the current pace of paediatric HIV Services, it can be extrapolated that paediatric ART coverage will increase from 26% to only about 40% by 2020; Ghana will, therefore, fall short of the global target of 90-90-90 (UNAIDS concept).
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The study sought to understand the factors that facilitate women to adhere to treatment
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and return to health facilities for routine care from their own perspective. The researchers focused on Malawi, Uganda and Zambia, early adopters of the global guidance to provide lifelong treatment for pregnant women living with HIV (Option B+) and spoke to women living with HIV, healthcare workers and programme managers to discover which factors and practices show promise in supporting women to initiate and remain in care.
This study found that women living with HIV who access these services to prevent vertical transmission have a strong sense and understanding of what factors support their retention and how health facilities, the wider community and their friends and relations can best support them. This report shares their words to describe how it feels to walk in their shoes on the path of life long treatment.
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“Continuum of HIV services refers to a comprehensive package of HIV prevention, diagnostic, treatment
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, care and support services provided for people at risk of HIV infection or living with HIV and their families”
August, 2018
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This joint publication by UNAIDS and WHO emphasizes the importance of integrating HIV prevention, testing, treatment
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and care and mental health services for people living with HIV. It provides a compilation of tools, best practices, recommendations and guidelines that facilitate the integration of interventions and services to address the interlinked issues of mental health and HIV. This publication is intended for global, regional and national policy-makers; programme implementers including at subnational levels; organizations working in and providers of HIV and mental health services; civil society; and community-based and community-led organizations and advocates.
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These are integrated National Guidelines 2013 for Prevention and Management of HIV, STIs & Other Blood Borne Infections in accordance with the last guidelines of the World Health Organization (WHO)
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published in June 2013 and adapted to the Rwandan national context. It thus responds to the need by the Ministry of Health to improve skills of actors in the health sector as well as the quality of care and treatment offered in both public and private health facilities countrywide.
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The report shows that where people and communities living with and affected by HIV are engaged in decision-making
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and HIV service delivery, new infections decline and more people living with HIV gain access to treatment. When people have the power to choose, to know, to thrive, to demand and to work together, lives are saved, injustices are prevented and dignity is restored.
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The 2030 health-related Sustainable Development Goals call on countries to end AIDS as a public health threat and also to achieve
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universal health coverage. The World Health Organization (WHO) promotes primary health care (PHC) as the key mechanism for achieving universal health coverage, and the PHC approach is also essential for ending AIDS and reaching other Sustainable Development Goal targets.
The PHC approach is defined as a whole-of-society approach to health that aims to maximize the level and distribution of health and well-being through three components: (1) primary care and essential public health functions as the core of integrated health services; (2) multisectoral policy and action; and (3) empowered people and communities.
This publication helps decision-makers to consider and optimize the synergies between existing and future assets and investments intended for both PHC and disease-specific responses, including HIV. Specifically, it aims to:
• provide guidance to policy-makers, health system managers and programmatic leads from both PHC and HIV backgrounds regarding opportunities to jointly advance their respective efforts to strengthen PHC and end AIDS as a public health threat; and
• provide a resource for all stakeholders who seek to contribute to strengthening PHC and ending AIDS as a public health threat in a synergistic manner, including people living with HIV, members of key and vulnerable populations, community and civil society representatives, people working in all areas of health systems, researchers, funders and private-sector decision-makers.
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The main aim of these guidelines is to enable the central units of national TB and HIV/AIDS programmes
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to support districts to plan, coordinate and implement collaborative TB/HIV activities. These guidelines reinforce current medical understanding, that highly active antiretroviral treatment (HAART) has decreased TB incidence of people living with HIV/AIDS. They are comprehensive, giving an overview of the range of activities that could be undertaken in high burden TB/HIV countries or where a rising prevalence of HIV might fuel TB. Activities highlight the need for comprehensive care, prevention and support for adults living with HIV/AIDS. Comprehensive TB and HIV care and prevention rely on full implementation of the DOTS strategy as part of a wide ranging HIV/AIDS care and prevention programme as well as collaborative TB and HIV programme activities.
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The objective of Critical Considerations and Actions for Achieving Universal Access to Sexual
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and Reproductive Health in the Context of Universal Health Coverage through a Primary Health Care Approach is to provide guidance to WHO Member States for ensuring progress towards universal access to comprehensive sexual and reproductive health (SRH) in the context of primary health care (PHC)- and universal health coverage (UHC)-related policy and strategy reforms.
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Purpose of this document: to present eight practical steps that Member States can take at the national and sub-national level to improve WASH in he
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alth care facilities
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MSF provides treatment for HIV and tuberculosis (TB) in more than 20 countries around the world. The report Burden sharing or burden shifting? How
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the HIV/TB response is being derailed examines the situation in nine countries where MSF runs programmes: Central African Republic, Democratic Republic of Congo, Eswatini, Guinea, Kenya, Malawi, Mozambique, Myanmar and Zimbabwe. With a focus on the financial resources available, this report highlights the current risks and gaps in HIV and TB service delivery in these countries.
Given the findings of gaps in diagnosis, prevention and care services and dwindling resources, MSF calls for a robust assessment of the needs and the resource capacity of each affected country, and calls on international donors to ensure that the financial burden is shared, rather than shifted onto those countries worst affected by the diseases.
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Towards Universal Access to Prevention, Diagnosis and
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Treatment
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