tailieunhanh - báo cáo hóa học:" Integration of HIV/AIDS services into African primary health care: lessons learned for health system strengthening in Mozambique a case study"

Tuyển tập các báo cáo nghiên cứu về hóa học được đăng trên tạp chí sinh học đề tài : Integration of HIV/AIDS services into African primary health care: lessons learned for health system strengthening in Mozambique a case study | Pfeiffer et al. Journal of the International AIDS Society 2010 13 3 http content 13 1 3 JOURNALOF THE INTERNATIONAL AIDS SOCIETY CASE STUDY Open Access Integration of HIV AIDS services into African primary health care lessons learned for health system strengthening in Mozambique -a case study James Pfeiffer1 2 Pablo Montoya1 2 Alberto J Baptista3 Marina Karagianis4 Marilia de Morais Pugas5 Mark Micek2 2 2 2 Wendy Johnson Kenneth Sherr Sarah Gimbel Shelagh Baird Barrot Lambdin Stephen Gloyd Abstract Introduction In 2004 Mozambique supported by large increases in international disease-specific funding initiated a national rapid scale-up of antiretroviral treatment ART and HIV care through a vertical Day Hospital approach. Though this model showed substantial increases in people receiving treatment it diverted scarce resources away from the primary health care PHC system. In 2005 the Ministry of Health MOH began an effort to use HIV AIDS treatment and care resources as a means to strengthen their PHC system. The MOH worked closely with a number of NGOs to integrate HIV programs more effectively into existing public-sector PHC services. Case Description In 2005 the Ministry of Health and Health Alliance International initiated an effort in two provinces to integrate ART into the existing primary health care system through health units distributed across 23 districts. Integration included a placing ART services in existing units b retraining existing workers c strengthening laboratories testing and referral linkages e expanding testing in TB wards f integrating HIV and antenatal services and g improving district-level management. Discussion By 2008 treatment was available in nearly 67 health facilities in 23 districts. Nearly 30 000 adults were on ART. Over 80 000 enrolled in the HIV AIDS program. Loss to follow-up from antenatal and TB testing to ART services has declined from 70 to less than 10 in many integrated sites. Average time from