Health Policy Issues and Health Programmes in ... - Amazon S3

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HIV/AIDS: International Perspectivealso culminates in discrimination and denial of care. These, in combination, render the affectedindividuals hide the disease. Any infectious disease epidemic thrives on the hidden orunidentified reservoir. Unless the disease is normalized, this segment of the infected individualswould continue to fuel the epidemic in a given community. The importance of removal ofstigma and normalization of the disease for success of prevention programmes is wellillustrated by the experiences of Switzerland and Australia in the case of IDUs and of Thailandwith CSWs. Notwithstanding their legal statutes, Switzerland and Australia promoted the needleexchange programmes and injecting centres and were effective in containing the spread ofinfection in their countries. Similarly, Thailand successfully implemented 100 per cent condompromotion among sex workers in the country and stands as the first country to reverse thetrend of the epidemic in the region. All the three examples highlight the need to tolerate andaccept some behavioural patterns as normal and initiate interventions with empathy.Figure 3Percentage HIV Positive5. Well-designed and supported prevention efforts can work. Response to preventive actionsis also variable in different countries. Response depends on identifying and targeting thecorrect population sub-groups, quality and coverage of the interventional inputs, andaccessibility and affordability of care. Since HIV requiressocial and behavioural change interventions inHIV Prevalence Among Pregnant Womenin Cambodia, 1997–2000divergent settings, the health sector alone can not meet5the demands. Rather, an adequate response requiresinvolvement of multiple sectors and inflow of additional43resources. Unless there is political commitment at thehighest level, neither an augmented resource flow normulti-sectoral involvement can be achieved effectively.2Cambodia (Figure 3), Thailand, and Uganda present uswith the best examples of political commitment leading10to implementation of quality interventions withadequate coverage. In Cambodia and Thailand, 100%19971998 1999 2000condom promotion in CSW settings enabled thecountries to lower the prevalence from over 3% to 2%.Source: National AIDS Prog ramme, CambodiaIn a recent study comparing the intervention inputs and achievements in four Africancountries, it was noted that although educational interventions were similar in all the countries,Uganda achieved better results and effectively lower HIV prevalence because of the quality of itsinterventions. In Uganda, unlike in the other countries, there was excellent diffusion ofeducational messages through personal communication by peers, which ultimately decreasedthe prevalence of high-risk behaviours and HIV. Such quality educational inputs that result ineffective diffusion of information are possible only with the highest levels of politicalcommitment and multi-sectoral involvement.174The following are, therefore, obvious.1. No community or country is immune to HIV.2. Sustained low-prevalence situations can suddenly turn into explosive epidemics.3. Situations need sustained and continuous monitoring. In low-prevalence situations,
HIV/AIDS: International Perspectivemonitoring of risk behaviours and indicator diseases among high-risk groups pays dividends.4. Denial, stigma, discrimination, and failure to provide equal access to migrants fuel theepidemic.5. Early interventions are more effective and cost-efficient.6. Early interventions facilitate restriction of epidemics to population sub-groups and thusprevent spread to the general population.7. Mere initiation of interventions may not pay dividends; the quality and coverage of theseinterventions decide the beneficial outcomes.High political commitment and multi-sectoral involvement are essential for ensuring theeffectiveness of interventions.175
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Health Policy IssuesandHealth Progr
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ContentsContentsPrefaceList of Part
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I would also like to thank our tech
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List of ParticipantsIndu Kumar Pand
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List of ParticipantsMohmed ShaukatD
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List of ParticipantsR K PurohitAddi
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GlossaryGlossaryAbbreviationsAIIMSA
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GlossaryLHVLILMISMAPMCMCHMDRTBMDTM&
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GlossaryTHRTRCTRIPsTTTUUDCUIPUPUTVC
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Inaugural Sessionwould be the first
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Inaugural SessionOnly 18% of the pr
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Inaugural SessionMadhukar Gupta, Ch
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Inaugural Sessionrotational basis f
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Inaugural Sessiontell you more abou
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Public Health Issues, Priorities, a
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National Health Programmes: An Over
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Implementation of National Health P
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Use of Epidemiological Surveillance
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Designing a Surveillance SystemFurt
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Designing a Surveillance Systemsurv
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National Health Programme in Uttara
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IEC Strategies for Health in IndiaS
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IEC Strategies for Health in Indial
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IEC Strategies for Health in IndiaS
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IEC Strategies for Health in IndiaA
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IEC for Health Programmes in Uttara
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Session 3Private and Public SectorP
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Public-Private Interaction in Healt
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Cost Recovery Measures in Governmen
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Arogya Raksha: Health Insurance Sch
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Page 172 and 173: Quality of RTI/STI Case Management
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Page 188 and 189: HIV/AIDS in India and UttaranchalSe
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Streamlining the Drug Procurement a
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Streamlining the Drug Procurement a
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Sanitation and Public Health Issues
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Ayurveda and Unani Department and t
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Specific Health Policy and Programm
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