Integrated Prevention Campaigns (IPCs):opportunities & challenges of a health delivery     platform for HIV, malaria & dia...
OverviewSynergies & efficiency gains of IPCs ?Equity gains of IPCs ?Opportunity costs of IPCs ?Broader health system i...
Health system delivery platforms                                             Policy Instruments                     (e.g. ...
Synergies & efficiency gains of IPCs ?                                                   VCT                              ...
Equity gains of IPCs ? Potential benefit of IPCs = enhanced outreach to underserved  (e.g. reach out to remote areas) Ef...
Opportunity costs of IPCs ? Implementation of IPCs requires large health workforce    - diversion from accomplishing rout...
Example: “Child Health Days” in sub-Saharan Africa Mass immunization campaigns  - delivery of multiple child health inter...
Broader health system connections of IPCs? IPC mostly targets adults    - opportunity for including other adult health in...
Acknowledgments• Aliya Jiwani                 • James G. Kahn• Elliot Marseille             • Alastair Matheson• Stephane ...
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Health Delivery Platform for HIV, Malaria & Diarrhea

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by Stephane Verguet
Department of Global Health
University of Washington
Presented at 2012 AIDS Satellite Meeting

Published in: Health & Medicine
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  • e.g. high burden/low coverage in remote areas
  • Health Delivery Platform for HIV, Malaria & Diarrhea

    1. 1. Integrated Prevention Campaigns (IPCs):opportunities & challenges of a health delivery platform for HIV, malaria & diarrhea Stéphane Verguet verguet@uw.edu Department of Global Health, University of Washington XIXth International AIDS Conference, Washington, DC, July 25, 2012
    2. 2. OverviewSynergies & efficiency gains of IPCs ?Equity gains of IPCs ?Opportunity costs of IPCs ?Broader health system integration of IPCs ? 2
    3. 3. Health system delivery platforms Policy Instruments (e.g. universal public finance; taxation; conditional cash transfers) Platform 1 Platform 2 Platform 2 Platform 1e.g. HIV-dedicated e.g. routine vaccine e.g. e.g. IPC Child Health Days clinic services (EPI) immunization campaigns WaterART ART DTP BCG Vitamin A Deworming filters VCT ITNs Measles Adult health Child health 3
    4. 4. Synergies & efficiency gains of IPCs ? VCT Referral to ART IPC platform ITNs Water filters ….May raise impact at low marginal cost with few add-onsImpact of add-ons due to: - biological synergies (e.g. competing risks, potentiation and antagonism) - operational synergies (e.g. logistical integration) - epidemiology and coverage of pre-existing interventions 4
    5. 5. Equity gains of IPCs ? Potential benefit of IPCs = enhanced outreach to underserved (e.g. reach out to remote areas) Effects of alternative IPC strategies on health disparities among sub-groups (wealth status, urban vs. rural): Are IPCs targeting the poorest ? ??? 5
    6. 6. Opportunity costs of IPCs ? Implementation of IPCs requires large health workforce - diversion from accomplishing routine duties What can be negative impacts on routine health services? - interruption of some services during IPC campaigns ? How to limit opportunity costs? - use non-technical workers e.g. community health workers (CHWs) - prioritize simple IPC interventions requiring unskilled workers 6
    7. 7. Example: “Child Health Days” in sub-Saharan Africa Mass immunization campaigns - delivery of multiple child health interventions polio, measles vaccines ITNs vitamin A deworming Case of South Africa’s Child Health Days (Verguet et al., 2012) - vitamin A inclusion much more cost-effective than stand-alone measles vaccine - use of routine health services decreases during platform implementation 7
    8. 8. Broader health system connections of IPCs? IPC mostly targets adults - opportunity for including other adult health interventions (e.g. TB) - opportunity for leveraging infrastructure for non-communicable diseases (e.g. hypertension, diabetes screening) IPC as a lever to strengthen health services? - integrate vertical disease programs and intersectoral policies - link communities to basic health services (e.g. child health example = México’s National Health Weeks (Sepúlveda et al., 2006)) 8
    9. 9. Acknowledgments• Aliya Jiwani • James G. Kahn• Elliot Marseille • Alastair Matheson• Stephane Verguet • Judd WalsonOpportunity Index – Lisa Manhart, Gillian Levine, PatriciaPavlinac, Adam Akullian, Arianna Rubin 9

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