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A cross-sectional qualitative study was conducted to explore early experiences surrounding "Option B+" for patients and health care workers in Malawi. As "Option B+" continues to be rolled out, novel interventions to support and retain women in care must be implemented. These include providing space, time, and support to accept a diagnosis before starting ART, engaging partners and families, and addressing the need for peer support and confidentiality.

Despite Namibia's robust medicine use systems and policies, antibiotic use indicators remain suboptimal. Recent medicine use surveys rank cotrimoxazole, amoxicillin and azithromycin (CAA) among the most used medicines. However, there is rising resistance to CAA (55.9%-96.7%). A quantitative text analysis found that policy and guidelines for antibiotic use in Namibia are not comprehensive and are skewed towards PHCs. Existing policies promote the wide use of CAA antibiotics, which may inadvertently result in their inappropriate use, enhancing resistance rates. This calls for the development of more comprehensive antibiotic guidelines and essential medicine lists in tandem with local antimicrobial resistance patterns. 

HIV among people who inject drugs (PWID) is a serious public health problem in Tajikistan and other Central Asian republics, yet relatively few studies have been conducted among PWID in Tajikistan and almost nothing is known about females who inject drugs. This presentation will examine gender differences in HIV status, injection risk behaviors and sex risk behaviors among PWID in Tajikistan.

The Global Burden of Disease 2015 article on maternal mortality by Nicholas Kassebaum and colleagues (Oct. 8, p. 1775) contains a serious error reflecting a basic misunderstanding of the Sustainable Development Goal (SDG) target for maternal mortality. The report states that “only ten countries achieved MDG 5, but 122 of 195 countries have already met SDG 3.1”. This is a dangerous and inaccurate interpretation of the global goal. The SDG target is a global target, not a country target. To achieve the global target for maternal mortality reduction requires every country to reduce its national maternal mortality ratio from baseline by two-thirds in that timeframe. It is probably safe to assume that no country has succeeded in reducing its maternal mortality ratio by two-thirds since the SDGs were launched in September 2015.

The objective of this study was to assess the feasibility and effectiveness of the nationally approved ambulatory service delivery model for MDR-TB treatment in two regions of Ethiopia. We used routinely reported data to describe the process and outcomes of implementing an ambulatory model for MDR-TB services in a resource-limited setting. Between 2012 and 2015, the number of MDR-TB treatment-initiating centers increased from 1 to 23. The number of sputum samples tested for MDR-TB increased 20-fold, from 662 to 14,361 per year. The backlog of patients on waiting lists was cleared. The cumulative number of MDR-TB patients put on treatment increased from 56 to 790, and the treatment success rate was 75%. Rapid expansion of the ambulatory model of MDR-TB care was feasible and achieved a high treatment success rate in two regions of Ethiopia.

The Ethiopian Paediatric HIV Cohort was established to identify clinical and laboratory predictors of virological treatment failure to ultimately develop a clinical–immunological prediction rule with area under the curve of >0.80 for detecting first-line antiretroviral therapy failure (ARTF). It will also assess the performance of the current WHO guidelines for detection of first-line ARTF in children. Using a prospective cohort design, HIV-infected children and adolescents below the age of 18 years are followed every 6 months with a set of clinical and laboratory parameters at 6 hospitals in southern Ethiopia. From October 2015 through April 2016, 628 children have been enrolled. The cohort will be completed in September 2017. The successful completion of this study will allow for better targeting of viral-load testing to those at highest risk in resource-poor settings and provide clinicians and policymakers with a practical prediction rule.

We assessed community awareness about cervical cancer risk factors and symptoms and perceptions about prevention and cure of cervical cancer in order to contribute data to inform interventions to improve cervical cancer survival. The study was conducted in Gulu, a post-conflict district in Uganda in 2012. The sample included 448 adults. Recognition of cervical cancer risk factors and symptoms was high among study participants. Targeted interventions including increasing availability of HPV vaccination, population-based cervical screening and diagnostic services can translate high awareness into actual benefits.

Our objective was to demonstrate the feasibility of integrated care for TB, HIV and diabetes mellitus (DM) in a pilot project in Ethiopia. Of 3439 study participants, 888 were patients with DM, 439 patients with TB and 2112 from HIV clinics. Tri-directional screening was feasible for detecting and managing previously undiagnosed TB and DM.

An intervention brought together community health workers, health facility staff, and accredited drug dispensing outlet (ADDO) dispensers to improve maternal and newborn health through a mechanism of collaboration and referral. Relationships among the three levels of care improved after the linkage intervention, especially for ADDO dispensers and health facility staff who previously had no formal communication pathway. The study participants' perceptions of success included improved knowledge of case management and relationships among the three levels of care, more timely access to care, increased numbers of patients/customers, more meetings between community health workers and health facility staff, and a decrease in child and maternal mortality.

In 1997, Milstien, Batson, and Meaney published ‘‘A Systematic Method for Evaluating the Potential Viability of Local Vaccine Producers.” The paper identified characteristics of successful vaccine manufacturers and developed a viability framework to evaluate their performance. This paper revisits the original study after two decades to determine the ability of the framework to predict manufacturer success. Considering the marked changes in the market and technology landscape since 1997, the authors find the viability framework to be predictive and a useful lens through which to evaluate manufacturer success or failure.

In October 2014, UNAIDS set treatment targets to help end the AIDS epidemic, known as the 90:90:90 goals.They seek to achieve the following by 2020: 90% of HIV infected persons know their status, 90% of HIV positive persons are placed on treatment, and 90% of those on treatment are virally suppressed.

Human resources for health challenges related to training, deploying, and sustaining an effective health workforce have remained a barrier to successful program implementation at different levels of the health system.As health facilities are now required to treat all identi ed HIV positive clients in line with the newTest and Treat guidelines for achieving the UNAIDS 90:90:90 goals, addressin

The strides made in Malawi's Chiradzulu District demonstrate improved data use at the facility level and that using performance charts can go a long way in improving program performance. As a result of the success in Chiradzulu, the initiative has been scaled up in all of the DHSS program areas.

The patient tracing system improved the delivery of HIV services in MSH-supported facilities in Malawi's Blantyre District. More than 50% of patients who had missed an appointment were brought back to care. Some patients who had self- transferred out to other facilities were identi ed and their outcomes recorded in the register.

Management Sciences for Health (MSH) has been assisting Malawi since 2003 to strengthen health care systems, increase disease preven- tion education, reduce maternal and childhood mortality rates, and expand access to quality HIV/AIDS services.

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To improve quality of HIV care in targeted districts, STAR-E scaled up the Ministery of Health quality improvement framework in March 2013. STAR-E targeted 66 facilities, including high volume and smaller facilities that were underperforming on key indicators.

Key populations, including sex workers, prisoners, and men who have sex with men (MSM), are disproportionately infected with and affected by HIV and AIDS. In 2014, HIV prevalence among sex workers globally was 12 times the prevalence of the mainstream population. Sex workers and other key and priority populations contribute substantially to new HIV infections in Uganda.

Uganda ranks among the top 20 countries in the world with the highest number of TB/HIV co-infection cases and the highest rate of TB cases among people living with HIV(PLHIV). In 2015, HIV prevalence was estimated at 7.1%, and approximately 45% of TB patients were co-infected with HIV.

The ongoing conflicts in Syria have had a major impact on the health of the population and have also reduced the capacity of health care service delivery to a minimum.

Recommendations for NCD Care in Low- and Middle-Income Country Settings

In February and March 2016, a team of MSH staff and consultants worked with the ministry of health, UNICEF/Malawi and other stakeholders to collect data that could be used to pilot the methodology and tool.

Economic studies show that investment in providing safe drinking water to the population and avoiding many deaths also generates many more productive days every year.

Family Care International, the International Center for Research on Women (ICRW) and the KEMRI-CDC Research and Public Health Collaboration conducted a research study in Kenya to document the financial and social costs of maternal death to families in a poor, remote community and the ways that these costs affect newborn survival, child health and education, and family well-being.

These briefing cards detail the linkages between sexual and reproductive health and rights (SRHR) and other key development issues including environmental sustainability, gender equality, economic growth, educational attainment, and broader health goals.

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