Towards an AIDS-free generation by 2030: how are South African children, adolescents, caregivers and health care workers coping with HIV?

2021 ◽  
pp. 008124632199217
Author(s):  
Yogan Pillay
Keyword(s):  
Health Care ◽  
Children And Adolescents ◽  
South African ◽  
Health Care Workers ◽  
Policy Makers ◽  
Number Of Children ◽  
Key Stakeholders ◽  
Care Workers ◽  
Free Generation ◽  
Living With Hiv

We are committed to an AIDS free generation by 2030 – nine short years away. This article reflects on the global and South African data on new infections, total number of children and adolescents living with HIV as well as data on vertical transmission. The article includes the voices of key stakeholders in the quest to end HIV in children so that lessons from their experiences can be used by policy makers in strengthening services.

scholarly journals Novel health system strategies for tuberculin skin test-guided Isoniazid preventive therapy

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Van Ginderdeuren ◽  
J Bassett ◽  
C F Hanrahan ◽  
L Mutunga ◽  
A Van Rie
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Health Care Workers ◽  
Fast Track ◽  
Task Shifting ◽  
Preventive Therapy ◽  
Fast Tracking ◽  
Care Workers ◽  
Provider Perspective ◽  
Living With Hiv

Abstract Background Global TB elimination demands a scale-up of Isoniazid preventive therapy (IPT) but tuberculin skin test (TST)-guided IPT poses great logistical and human resource challenges. Objectives Performance of TST self-reading by patients and fast-track TST reading by trained low cadre health care workers (task-shifting) was compared to formal TST reading by high cadre staff in a cohort of 278 South African adults living with HIV. Health economic impact of these novel strategies was assessed from a provider and societal perspective and simulations were performed for 5 other countries (USA, Germany, Brazil, India, Russia) to evaluate generalizability. In addition, accuracy of TST at antiretroviral treatment (ART) initiation was assessed by a repeat TST 6 and 12 month later. Results TST self-reading was highly accurate, with 89% sensitivity (95% CI 80, 95) and 100% specificity (95% CI 97,100) for detecting presence/absence of any induration. Agreement in TST reading between low and high cadre health care workers was very high (kappa 0.97). Compared to standard of care, a combined fast-track, task-shifting and self-reading strategy reduced TST reading costs in South Africa from a patient perspective by 81% and from a provider perspective by 92%. In all 5 countries simulated, TST reading cost was reduced by ≥ 78 % from a provider perspective. Repeat testing at 6 and 12 months showed high (31%, 95% CI 23, 40) TST conversion during the first 12 months of ART. Conclusions Empiric IPT for all people living with HIV followed by TST assessment after 6 or 12 months to identify those in need for lifelong IPT could increase the effectiveness of IPT programs. TST self-reading to reduce the number of patients that need to return for TST reading (to only those patients with self-determined presence of any induration) together with fast-tracking and task-shifting of TST reading could increase cost-effectiveness and reduce patient costs associated with IPT programs. Key messages Novel strategies are essential to control TB. Task-shifting, fast-tracking and patient TST self-reading empower patients and HCWs; optimal TST timing can increase cost-effectiveness of IPT programs.

scholarly journals The 3-I framework: a framework for developing public policies regarding pharmacogenomics (PGx) testing in Canada

Genome ◽  
2015 ◽  
Vol 58 (12) ◽  
pp. 527-540 ◽  
Author(s):  
Naazish S. Bashir ◽  
Wendy J. Ungar
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Policy Development ◽  
Organizational Level ◽  
Policy Makers ◽  
New Approach ◽  
Development Tool ◽  
Care Workers ◽  
Developed Nations ◽  
Confidentiality And Privacy

The 3-I framework of analyzing the ideas, interests, and institutions around a topic has been used by political scientists to guide public policy development. In Canada, there is a lack of policy governing pharmacogenomics (PGx) testing compared to other developed nations. The goal of this study was to use the 3-I framework, a policy development tool, and apply it to PGx testing to identify and analyze areas where current policy is limited and challenges exist in bringing PGx testing into wide-spread clinical practice in Canada. A scoping review of the literature was conducted to determine the extent and challenges of PGx policy implementation at federal and provincial levels. Based on the 3-I analysis, contentious ideas related to PGx are (i) genetic discrimination, (ii) informed consent, (iii) the lack of knowledge about PGx in health care, (iv) the value of PGx testing, (v) the roles of health care workers in the coordination of PGx services, and (vi) confidentiality and privacy. The 3-I framework is a useful tool for policy makers, and applying it to PGx policy development is a new approach in Canadian genomics. Policy makers at every organizational level can use this analysis to help develop targeted PGx policies.

scholarly journals Impact of COVID-19 Pandemic on Mental Health of the General Population, Students, and Health Care Workers: A Review

2020 ◽  
Author(s):  
Sabina Sankhi ◽  
Nirmal Raj Marasine
Keyword(s):  
Mental Health ◽  
Health Care ◽  
General Population ◽  
Health Care Workers ◽  
Rural Areas ◽  
Psychological Reactions ◽  
Policy Makers ◽  
Lower Socioeconomic ◽  
Care Workers ◽  
The Impact

Background: The COVID-19 among humans is spreading heavily and is largely impacting the mental health of the general population, students, and health care workers worldwide. Hence, this review aims to summarize the literatures addressing the impact of the COVID-19 pandemic on the mental health of the general population, students, and health care workers. Methods: Published articles concerning mental health of the general population, students, and health care workers related to the COVID-19 outbreak have been considered and reviewed. Results and Discussion: Mental health symptoms of stress, anxiety, and depression are common psychological reactions to the COVID-19 pandemic in the general population, students, and health care workers. This collectively influences daily behavior, economy, prevention strategies and decision making from policy makers and health organizations, weakening the strategies of COVID-19 control leading to more morbidity and mental health needs at the global level. Conclusion: There is a need for more evidence-based research from other affected countries, particularly in vulnerable populations such as children and adolescents, people of lower socioeconomic status, and those residing in rural areas, so that valid strategies can be developed and COVID-19 and outbreaks of similar types in the near future can be prevented.

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