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Effective implementation of policies for expanding antiretroviral therapy (ART) requires a well-trained and adequately staffed workforce. Changes in national HIV workforce policies, health facility practices, and provider experiences were examined in rural Malawi and Tanzania between 2013 and 2017. In both countries, task-shifting and task-sharing policies were explicit by 2013. In facilities, the cadre mix of providers varied by site and changed over time, with a higher and growing proportion of lower cadre staff in the Malawi site. In Malawi, the introduction of lay counsellors was perceived to have eased the workload of other providers, but lay counsellors reported inadequate support. Both countries had guidance on the minimum numbers of personnel required to deliver HIV services. However, patient loads per provider increased in both settings for HIV tests and visits by ART patients and were not met with corresponding increases in provider capacity in either setting. Providers reported this as a challenge. Although increasing patient numbers bodes well for achieving universal antiretroviral therapy coverage, the quality of care may be undermined by increased workloads and insufficient provider training. Task-shifting strategies may help address workload concerns, but require careful monitoring, supervision and mentoring to ensure effective implementation.

Many people are not getting the HIV/AIDS services they need due to lack of health care providers. And paying the salaries of health personnel consumes a major proportion of national budgets for health services—up to 75 percent in some countries.

The international community has compelling humanitarian, political, security, and economic reasons to become involved in fragile states.

As a recent international conference initiated and hosted by Afghanistan showed, there is no substitute for collaborative action fuelled by a common vision – and when it comes to eradicating the six deadliest diseases in the world today (HIV/AIDS, malaria, cholera, polio, tuberculosis and avian influenza), political boundaries and territorial conflicts become irrelevant.

In many countries, preventing, detecting, and treating sexually transmitted diseases (STDs) are essential parts of reproductive health services. In light of the pandemic of the human immunodeficiency viruses (HIV) and acquired immunodeficiency disease (AIDS) and the roleof STDs in making men and women more vulnerable to HIV infection, STD services are receiving increased attention.

Since the 1994 International Conference on Population and Development (ICPD) in Cairo, family planning managers are rising to the challenge to offer a broader scope of reproductive health services to their clients.

Purpose: To standardize and improve data collection instruments and practices for monitoring and evaluation of HIV/AIDS prevention programs. Description:

Purpose: The purpose of this manual is to provide a set of flexible, adaptable tools, and guidelines to support supervisors in their role of improving the quality of care in the clinics. It is especially helpful for focusing managers on the key elements of integrated primary health care as they simultaneously integrate new interventions for HIV/AIDS, tuberculosis, and malaria.Description:

UNAIDS estimates that about 2.6 million children (aged 0-14) were living with HIV/AIDS in sub-Saharan Africa at the end of the year 2001, and most of these HIV infections were a result of mother-to-child transmission (MTCT) of HIV. In the same year, about 11 million children aged 0-14 were orphans as a result of their parent or parents' AIDSrelated death.

The essential medicines concept has become an established approach in international public health – a vital component for combating HIV/AIDS, tuberculosis, malaria, respiratory infections, other communicable diseases and the vast majority of non-communicable diseases. But the survival and global dissemination of the essential medicines concept were by no means assured at the outset.  

Background: HIV prevalence among pregnant women in Malawi is 12.6%, and mother-to-child transmission is a major route of transmission. As PMTCT services have expanded in Malawi in recent years, we sought to determine uptake of services, HIV-relevant infant feeding practices and mother-child health outcomes.

The Need for Change Management

Objective  To describe how district-wide access to HIV/AIDS care was achieved and maintained in Thyolo District, Malawi. Method  In mid-2003, the Ministry of Health and Médecins Sans Frontières developed a model of care for Thyolo district (population 587 455) based on decentralization of care to health centres and community sites and task shifting.

The debate on the interaction between disease-specific programmes and health system strengthening in the last few years has intensified as experts seek to tease out common ground and find solutions and synergies to bridge the divide. Unfortunately, the debate continues to be largely academic and devoid of specificity, resulting in the issues being irrelevant to health care workers on the ground.

In the CIPRA-SA trial (July 3, p. 33), Ian Sanne and colleagues compared the outcomes of nurse-monitored patients with those of doctor-monitored patients in an antiretroviral treatment (ART) program in South Africa and concluded that the outcomes of ART services provided by nurses were non-inferior to those provided by doctors.

Background:Increased availability and accessibility of antiretroviral therapy (ART) has improved the length and quality of life amongst people living with HIV/AIDS. This has changed the landscape for care from episodic to long-term care that requires more monitoring of adherence. This has led to increased demand on human resources, a major problem for most ART programs.

Our aim was to explore peer counselors' work and their role in supporting patients' adherence to antiretroviral treatment (ART) in resource-limited settings in Ethiopia and Uganda. Qualitative semi-structured interviews were conducted with 79 patients, 17 peer counselors, and 22 providers in ART facilities in urban and rural areas of Ethiopia and Uganda.

In Malawi, high case fatality rates in patients with tuberculosis, who were also co-infected with HIV, and high early death rates in people living with HIV during the initiation of antiretroviral treatment (ART) adversely impacted on treatment outcomes for the national tuberculosis and ART programmes respectively. This article (1) discusses the operational research that was conducted in the country on cotrimoxazole preventive therapy, (2) outlines the steps that were taken to translate these findings into national policy and practice, (3) shows how the implementation of cotrimoxazole preventive therapy for both TB patients and HIV-infected patients starting ART was associated with reduced death rates, and (4) highlights lessons applicable to other settings and interventions.

Among adults eligible for antiretroviral therapy (ART) in Thyolo (rural Malawi) and Kibera (Nairobi, Kenya), this study (1) reports on retention and attrition during the preparation phase and after starting ART and (2) identifies risk factors associated with attrition.

St. Vincent and the Grenadines (SVG) is the largest marijuana producer in the Eastern Caribbean. As the European Union has phased out preferred access for its banana crop, marijuana has become one of the main sources of income and a safety net for many young men, in particular.

The national scale-up of antiretroviral therapy (ART) in Malawi is based on a public health approach, with principles and practices borrowed from the successful DOTS tuberculosis control framework. During the first 6 years, the number of patients registered on treatment increased from 3,000 to >350,000 in both the public and private sectors.

The objective of this study was to determine extent of HIV conspiracy belief endorsement among men who have sex with men (MSM) in Pretoria, and assess whether endorsement of HIV conspiracy beliefs are associated with inconsistent condom use and never testing for HIV. A cross-sectional survey using respondent-driven sampling was conducted between February and August 2009.

Background Secondary infertility is a common, preventable but neglected reproductive health problem in resource-poor countries. This study examines the association of past sexually transmitted infections (STIs) including HIV, bacterial vaginosis, and factors in the obstetric history with secondary infertility and their relative contributions to secondary infertility. Methods

Apegnon Akpene is a 20 year-old mother of three: four year-old Joseph, two year-old Romance and one month-old Akou Jacqueline.

In most countries, tuberculosis (TB) services are decentralized up to the most peripheral health facilities and often into the community. On the other hand, HIV/AIDS services are generally much more centralized because scale-up of services, especially of antiretroviral therapy (ART), started only quite recently.

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