scholarly journals Pre-exposure prophylaxis rollout in a national public sector program: the Kenyan case study

Sexual Health ◽  
2018 ◽  
Vol 15 (6) ◽  
pp. 578 ◽  
Author(s):  
Sarah Masyuko ◽  
Irene Mukui ◽  
Olivia Njathi ◽  
Maureen Kimani ◽  
Patricia Oluoch ◽  
...  
Keyword(s):  
Public Sector ◽  
Hiv Prevention ◽  
Scale Up ◽  
Hiv Infections ◽  
Sub Saharan Africa ◽  
Health Providers ◽  
Middle Income ◽  
The Government ◽  
Exposure Prophylaxis

Background While advances have been made in HIV prevention and treatment, new HIV infections continue to occur. The introduction of pre-exposure prophylaxis (PrEP) as an additional HIV prevention option for those at high risk of HIV may change the landscape of the HIV epidemic, especially in sub-Saharan Africa, which bears the greatest HIV burden. Methods: This paper details Kenya’s experience of PrEP rollout as a national public sector program. The process of a national rollout of PrEP guidance, partnerships, challenges, lessons learnt and progress related to national scale up of PrEP in Kenya, as of 2018, is described. National rollout of PrEP was strongly lead by the government, and work was executed through a multidisciplinary, multi-organisation dedicated team. This required reviewing available evidence, providing guidance to health providers, integration into existing logistic and health information systems, robust communication and community engagement. Mapping of the response showed that subnational levels had existing infrastructure but required targeted resources to catalyse PrEP provision. Rollout scenarios were developed and adopted, with prioritisation of 19 counties focusing on high incidence area and high potential PrEP users to maximise impact and minimise costs. Results: PrEP is now offered in over 900 facilities countrywide. There are currently over 14000 PrEP users 1 year after launching PrEP.Conclusions: Kenya becomes the first African country to rollout PrEP as a national program, in the public sector. This case study will provide guidance for low- and middle-income countries planning the rollout of PrEP in response to both generalised and concentrated epidemics.

scholarly journals Integration of HIV and sexual and reproductive health in the era of anti-retroviral-based prevention: findings from assessments in Kenya, Malawi and Zimbabwe

2021 ◽  
Vol 5 ◽  
pp. 145
Author(s):  
Fannie Kachale ◽  
Imelda Mahaka ◽  
Fatima Mhuriro ◽  
Mary Mugambi ◽  
Joseph Murungu ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Reproductive Health ◽  
Program Implementation ◽  
Sexual And Reproductive Health ◽  
Scale Up ◽  
Hiv Infections ◽  
Sub Saharan Africa ◽  
Structural Factors ◽  
Hiv Epidemic ◽  
Key Informant

Background: Though substantial progress has been made to curb the HIV epidemic, high rates of new HIV infections persist among adolescent girls and young women (AGYW) in sub-Saharan Africa, reflecting critical gaps in reaching them with integrated HIV prevention and sexual and reproductive health (SRH) services. With the scale-up of oral pre-exposure prophylaxis (PrEP) and multiple novel HIV prevention products on the horizon, countries have a unique opportunity to expand innovative approaches to deliver comprehensive, integrated HIV/SRH services. Methods: This article is a comparative analysis of findings from rapid landscaping analyses in Kenya, Malawi and Zimbabwe to highlight cross-country trends and context-specific realities around HIV/SRH integration. The analyses in Kenya and Zimbabwe were completed by Ministries of Health (MOH) and the HIV Prevention Market Manager project and include 20 health facility assessments, 73 key informant interviews and six community dialogues. In Malawi, the analysis was completed by the MOH and Georgetown University Center for Innovation in Global Health and includes 70 key informant interviews and a review of national policies and program implementation in Blantyre. Findings were validated through a review of literature and policies in each country. Results: The policy environment in all three countries is conducive to HIV/SRH integration, though operationalization continues to present challenges, with most policies preceding and not accounting for oral PrEP rollout. National coordination mechanisms, youth-friendly health services and prevention of mother-to-child transmission programs are promising practices, while siloed and resource-constrained health systems, limited provider capacity, lack of support for demand generation and structural factors exacerbate barriers to achieving integration. Conclusions: As new HIV prevention products are introduced, demand for integrated HIV/SRH services is likely to grow. Investing in HIV/SRH integration can help to ensure sustainable, government-led responses to the HIV epidemic, streamline service delivery and improve the health outcomes and lives of AGYW.

scholarly journals Role of Public Sector Bank in Financial Inclusion of Low or Middle Income Group in Chennai

2019 ◽  
Vol 8 (4S3) ◽  
pp. 40-44
Keyword(s):  
Public Sector ◽  
Low Income ◽  
Income Group ◽  
Financial Inclusion ◽  
Behavioral Ethics ◽  
Economic Equality ◽  
Middle Income ◽  
Middle Income Group ◽  
The Government

The role of public sector bank, in raising the economic equality on low income or middle income group, the term financial inclusion emphasis on redistribution of income within the same household, the deprive section of society avail the benefit with some standard provided by the government and how the approach have been taken by public sector bank to distribute the same and their behavioral ethics trail over the schemes. The study focused the dominant properties which fabricate imperative on financial inclusion among various categories of customers in public sector banks and also investigated the recognition of public in stand point of financial assistance and financial features offered by public sector bank through correlation statistical analysis with the sample of 200 with Chennai arena..

Health system adaptations and considerations to facilitate optimal oral pre-exposure prophylaxis scale-up in sub-Saharan Africa

2021 ◽  
Author(s):  
Daniel K Were ◽  
Abednego Musau ◽  
Kaitlyn Atkins ◽  
Prakriti Shrestha ◽  
Jason Reed ◽  
...  
Keyword(s):  
Health System ◽  
Scale Up ◽  
Sub Saharan Africa ◽  
Sub Saharan ◽  
Exposure Prophylaxis

Public-Private-Academic Cooperation as a Trust Building Mechanism

2016 ◽  
pp. 199-223
Author(s):  
Nicholas Virzi ◽  
Juan Portillo ◽  
Mariela Aguirre
Keyword(s):  
Public Sector ◽  
Private Sector ◽  
Trust Building ◽  
Public And Private ◽  
The Public ◽  
National Competitiveness ◽  
Working Together ◽  
The Government ◽  
Innovation And Entrepreneurship

The chapter will be a case study from an Ordoliberal perspective of the conception, implementation and policy output of the newly created Private Council of Competitiveness (PCC) in Guatemala, a country wracked by mistrust of the public sector by the private sector. The PCC was founded as a private sector initiative, in conjunction with academia, to work with the government to spawn new efforts aimed at augmenting Guatemala's national competitiveness, by fomenting innovation, entrepreneurship and closer ties between academia and the public and private sectors. The chapter utilizes first hand interviews with the members of the PCC and key public sector players, academics, and other top representatives from the private sector to show how working together built the trust necessary to make the PCC a successful working body with the potential to produce important initiatives in matters of competitiveness, innovation and entrepreneurship.

scholarly journals Recent declines in HIV infections at Silom Community Clinic Bangkok, Thailand corresponding to HIV prevention scale up: An open cohort assessment 2005–2018

2020 ◽  
Vol 99 ◽  
pp. 131-137
Author(s):  
Sarika Pattanasin ◽  
Frits van Griensven ◽  
Philip A. Mock ◽  
Wichuda Sukwicha ◽  
Santi Winaitham ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Scale Up ◽  
Hiv Infections ◽  
Community Clinic

Making prevention public: The co-production of gender and technology in HIV prevention research

2012 ◽  
Vol 42 (6) ◽  
pp. 922-944 ◽  
Author(s):  
Catherine M. Montgomery
Keyword(s):  
Hiv Prevention ◽  
New Technologies ◽  
Sub Saharan Africa ◽  
Therapeutic Success ◽  
Vaginal Microbicides ◽  
Gender And Technology ◽  
Sub Saharan ◽  
The Uk ◽  
Design And Testing

This paper brings together the study of transnational flows in global health and the gendering of technological artefacts. It does so through a case study of vaginal microbicides for HIV prevention, which have commonly been advocated for as a tool for women’s empowerment in parts of the world where HIV is most prevalent, namely sub-Saharan Africa. Drawing on fieldwork in the UK and Zambia, I argue that there is nothing inherently gendered about this ‘woman-controlled’ technology. Combining the notions of scripting and ‘making things public’, I demonstrate the political nature of transnational technology design and testing in the field of sexual health. Rather than framing this in terms of ethical debates, as is frequently the case in studies about the ‘global South’, I ground the analysis in the scripting and de-scripting of technologies and users. By focusing on how things are made public in HIV prevention, I draw attention to the normative, transformative and political potentials of new technologies, such as microbicides, and discuss the implications for their therapeutic success.

scholarly journals Intervention studies for improving global health and health care: An important arena for epidemiologists

2009 ◽  
Vol 15 (2) ◽  
Author(s):  
Gunnar Kvåle ◽  
H. Sommerfelt ◽  
K. Fylkesnes
Keyword(s):  
Health Care ◽  
Large Scale ◽  
Intervention Studies ◽  
Care Delivery ◽  
Hiv Infections ◽  
Evidence Base ◽  
Health Problems ◽  
Sub Saharan Africa ◽  
Public Health Importance ◽  
Middle Income

Marginalised populations in many low- and middle-income countries experience an increasing burden of disease, in sub-Saharan Africa to a large extent due to faltering health systems and serious HIV epidemics. Also other poverty related diseases (PRDs) are prevalent, especially respiratory and diarrhoeal diseases in children, malnutrition, maternal and perinatal health problems, tuberculosis and malaria. Daily, nearly 30,000 children under the age of 5 die, most from preventable causes, and 8,000 people die from HIV infections. In spite of the availability of powerful preventive and therapeutic tools for combating these PRDs, their implementation, especially in terms of equitable delivery, leaves much to be desired. The research community must address this tragic gap between knowledge and implementation. Epidemiologists have a very important role to play in conducting studies on diseases that account for the largest share of the global disease burden. A shift of focus of epidemiologic research towards intervention studies addressing health problems of major public health importance for disadvantaged population groups is needed. There is a need to generate an evidence-base for interventions that can be implemented on a large scale; this can result in increased funding of health promotion programs as well as enable rational prioritization and integration between different health interventions. This will require close and synergetic teamwork between epidemiologists and other professions across disciplines and sectors. In this way epidemiologists can contribute significantly to improve health and optimise health care delivery for marginalized populations.

scholarly journals PrEP in India’s HIV Prevention Policy in the Era of Social Media and Sex Positivity

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Anindya Kar ◽  
Dinesh Bhugra ◽  
Shuvankar Mukherjee ◽  
Agnibho Mondal ◽  
Aaditya Suresh Kumar
Keyword(s):  
Social Media ◽  
Hiv Prevention ◽  
Hiv Infection ◽  
International Studies ◽  
Cultural Transition ◽  
Prevention Policy ◽  
Online Social Media ◽  
Seeking Behavior ◽  
The Government ◽  
Exposure Prophylaxis

Introduction: The global revolution of online social media and connectivity had a tremendous effect on sexual behavior in both developed and developing countries. This global change is influencing the societal structure and existing social principles. Moreover, it has a significant impact on the epidemiology of different infectious diseases, especially HIV.Discussion: India is one of the most diverse democratic countries that has undergone a social-cultural transition in the last decade. However, having the second-highest HIV infection rate in the world, India does not have any other new prevention tools in their national HIV prevention strategy. Pre-Exposure Prophylaxis (PrEP), a boon of HIV prevention widely used in different countries, is still not implemented in India. The concept of “Digital India” by the Government of India is giving wide access of internet to the people of India. Furthermore, people are exposed to social media, and that is impacting their sex seeking behavior. Interestingly, recent legal changes in India promotes sex positivity. It also calls for introspection on existing HIV preventive strategies.Conclusion: Given the current scenario of PrEP and other existing preventive measurements of HIV, further research is needed to determine the acceptance and efficacy of PrEP and improve engagement in care for individuals in India. Various international studies recommend effective implication of PrEP to reduce the rate and economic burden of HIV infection.

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