This document provides information about an upcoming webinar on Sexually Transmitted and Blood Borne Infections (STBBIs) hosted by the Canadian Public Health Association (CPHA). The webinar will introduce a new STBBI Health Equity Impact Assessment Tool developed by CPHA. The summary also includes an example scenario of how the tool could be used to assess a campaign aimed at reducing STBBI rates in a small coastal town. By using the tool, potential unintended impacts are identified for different populations in the community, such as increased stigma, isolation, or a false sense of security. The tool aims to help organizations develop more equitable prevention initiatives.
This document provides an overview and summary of a webinar presented by the Canadian Public Health Association (CPHA) on STBBI/HIV community partner webinars. The webinar covered three topics: core competencies for STBBI prevention, an STBBI health equity impact assessment tool, and factors that impact vulnerability. It describes the development process for each of these three documents, which involved consultations and focus groups across Canada. It also outlines how these documents can be implemented and used by organizations and front-line workers.
The Women's Justice and Empowerment Initiative (WJEI) was a 3-year program from 2008-2011 that aimed to bolster women's justice and empowerment in 4 countries: Benin, Kenya, South Africa, and Zambia. The initiative had 3 components: raising GBV awareness, providing legal system support, and care/support for survivors. Evaluations found country-specific strengths like strengthened legal frameworks and improved services, but also challenges around sustainability, coordination, and meeting all survivor needs. Key recommendations included better coordination across donor sectors, integrated survivor services, sharing experiences across countries, and improved M&E.
The document summarizes the work of Calgary Urban Project Society (CUPS), a non-profit organization that provides integrated health, education, and housing services to help vulnerable Calgarians overcome poverty. It describes CUPS' proposed CUPS Coordinated Care Team, which would provide intensive case management and transitional support to vulnerable patients presenting at Emergency Departments, with the goal of improving health outcomes, reducing healthcare costs, and decreasing homelessness and substance abuse rates. The team would be funded by the Green Shield Canada Foundation through a two-year pilot project at the Foothills Medical Centre.
How Inclusive Design and Programming Advances UHCSantita Ngo
With 15 percent of the world's population living with some form of disability, this Technical Learning Sessions discussed how MSH's Universal Health Coverage (UHC) priorities cannot be realized without inclusion and specifically how the LMG Project has engaged in this space. Topics explored: the need for inclusive development, how to consider inclusion throughout the project cycle, and practical resources to use in your current work, regardless of the health area or building block you focus on.
This is the Plenary Presentation of CheyLeaphy Heng, Program Team Manager, Rainbow Community Kampuchea (RoCK) on the plenary topic: "UPR as an advocacy strategy for SOGIE-SC issues in Cambodia". This presentation was part of the 14th session of #APCRSHR10 Virtual, on the theme of "Sexual orientation and gender identity and SRHR in Asia Pacific".
Chair: Dr Chivorn Var, Convener of APCRSHR10 and Executive Director of Reproductive Health Association of Cambodia (RHAC)
Plenary Speaker: CheyLeaphy Heng, Program Team Manager, Rainbow Community Kampuchea (RoCK) | "UPR as an advocacy strategy for SOGIE-SC issues in Cambodia"
ABSTRACT PRESENTERS:
* Saroj Tamang | Male-to-Female Transgender Community barrier and challenges in access of Sexual Health Services
* Saritha P Viswan | A review of transgender issues in India
* Sobo Malik | Limited Access to Health Rights Resulting in Increase Self Medication
* Ciptasari Prabhawanti | Sexual Identity, Sexual Orientation, Sexual Risk and Condom Use Behaviors of Clients of Transgender Sex Workers in Jakarta, Indonesia
For further information, visit www.bit.ly/apcrshr10virtual14
Conference website: www.apcrshr10cambodia.org or check out www.bit.ly/apcrshr10virtual
Thanks
From Advocacy to Accountability: Empowering communities throughout the UHC Pr...HFG Project
This presentation was presented by Ricardo Valladares Cardona at a side session at the Prince Mahidol Award Conference (PMAC) in Bangkok, Thailand, on January 29, 2017.
This document summarizes a conference session on crafting advocacy messages for non-communicable diseases (NCDs). The session included presentations on NCD programs in Kenya, including the Healthy Heart Africa initiative to address hypertension. Small group discussions focused on integrating NCD care, key messaging, and gaps. Presenters emphasized the large global burden of NCDs, especially in low and middle income countries, and advocated for integrated NCD prevention and treatment approaches within existing health platforms using a multi-sectoral strategy.
This document provides an overview and summary of a webinar presented by the Canadian Public Health Association (CPHA) on STBBI/HIV community partner webinars. The webinar covered three topics: core competencies for STBBI prevention, an STBBI health equity impact assessment tool, and factors that impact vulnerability. It describes the development process for each of these three documents, which involved consultations and focus groups across Canada. It also outlines how these documents can be implemented and used by organizations and front-line workers.
The Women's Justice and Empowerment Initiative (WJEI) was a 3-year program from 2008-2011 that aimed to bolster women's justice and empowerment in 4 countries: Benin, Kenya, South Africa, and Zambia. The initiative had 3 components: raising GBV awareness, providing legal system support, and care/support for survivors. Evaluations found country-specific strengths like strengthened legal frameworks and improved services, but also challenges around sustainability, coordination, and meeting all survivor needs. Key recommendations included better coordination across donor sectors, integrated survivor services, sharing experiences across countries, and improved M&E.
The document summarizes the work of Calgary Urban Project Society (CUPS), a non-profit organization that provides integrated health, education, and housing services to help vulnerable Calgarians overcome poverty. It describes CUPS' proposed CUPS Coordinated Care Team, which would provide intensive case management and transitional support to vulnerable patients presenting at Emergency Departments, with the goal of improving health outcomes, reducing healthcare costs, and decreasing homelessness and substance abuse rates. The team would be funded by the Green Shield Canada Foundation through a two-year pilot project at the Foothills Medical Centre.
How Inclusive Design and Programming Advances UHCSantita Ngo
With 15 percent of the world's population living with some form of disability, this Technical Learning Sessions discussed how MSH's Universal Health Coverage (UHC) priorities cannot be realized without inclusion and specifically how the LMG Project has engaged in this space. Topics explored: the need for inclusive development, how to consider inclusion throughout the project cycle, and practical resources to use in your current work, regardless of the health area or building block you focus on.
This is the Plenary Presentation of CheyLeaphy Heng, Program Team Manager, Rainbow Community Kampuchea (RoCK) on the plenary topic: "UPR as an advocacy strategy for SOGIE-SC issues in Cambodia". This presentation was part of the 14th session of #APCRSHR10 Virtual, on the theme of "Sexual orientation and gender identity and SRHR in Asia Pacific".
Chair: Dr Chivorn Var, Convener of APCRSHR10 and Executive Director of Reproductive Health Association of Cambodia (RHAC)
Plenary Speaker: CheyLeaphy Heng, Program Team Manager, Rainbow Community Kampuchea (RoCK) | "UPR as an advocacy strategy for SOGIE-SC issues in Cambodia"
ABSTRACT PRESENTERS:
* Saroj Tamang | Male-to-Female Transgender Community barrier and challenges in access of Sexual Health Services
* Saritha P Viswan | A review of transgender issues in India
* Sobo Malik | Limited Access to Health Rights Resulting in Increase Self Medication
* Ciptasari Prabhawanti | Sexual Identity, Sexual Orientation, Sexual Risk and Condom Use Behaviors of Clients of Transgender Sex Workers in Jakarta, Indonesia
For further information, visit www.bit.ly/apcrshr10virtual14
Conference website: www.apcrshr10cambodia.org or check out www.bit.ly/apcrshr10virtual
Thanks
From Advocacy to Accountability: Empowering communities throughout the UHC Pr...HFG Project
This presentation was presented by Ricardo Valladares Cardona at a side session at the Prince Mahidol Award Conference (PMAC) in Bangkok, Thailand, on January 29, 2017.
This document summarizes a conference session on crafting advocacy messages for non-communicable diseases (NCDs). The session included presentations on NCD programs in Kenya, including the Healthy Heart Africa initiative to address hypertension. Small group discussions focused on integrating NCD care, key messaging, and gaps. Presenters emphasized the large global burden of NCDs, especially in low and middle income countries, and advocated for integrated NCD prevention and treatment approaches within existing health platforms using a multi-sectoral strategy.
The general population HIV prevalence stands at 5.1%(THMIS 2011/12) down from 18% in 1990.
HIV and STIs prevalence are also high among KP's, HIV is 31.4% while other STI has an average of 26% prevalence.
The number of KP's is not known, although there are fledgling groups of KP's which have started advocating for the Right to Health of KP's including protection against HIV infection, care and treatment to PLHIV KP's.
Sector planning-strategies-and-their-implementation-water for allAicha Chorak Franky
Here are a few key things I would consider taking forward based on the GLAAS results and discussion:
- Schedule time at our next senior management/country team meeting to review and discuss the GLAAS results for our country/countries in more depth. This will help identify strengths and gaps to inform our strategy and planning.
- Review our country strategy and annual workplans to ensure they are adequately addressing any gaps or weaknesses identified through GLAAS related to strengthening national systems. This may require revising objectives, targets or activities.
- Engage with other stakeholders like the government through our existing coordination platforms to discuss GLAAS findings and explore opportunities for collaboration to strengthen areas like policy development, planning, monitoring and finance mobil
This document summarizes LVCT Health's experience building the capacities of organizations led by people with disabilities (DPOs) in Nyanza, Kenya to improve access to sexual and reproductive health and HIV services. LVCT Health used a participatory approach to provide training, mentorship, and coaching to three DPOs over three years. As a result, the DPOs gained stable income sources, policy documents, referral systems, and the ability to engage in advocacy. The process showed that peer-led DPOs are effective, and working with them requires patience and sustained support. There is a need to better include people with disabilities in national health planning and make services more accessible and sensitive to their needs.
Practical Guidance for Incorporating Health Equity Learning_Jennifer Winestoc...CORE Group
This document outlines guidance from the Maternal and Child Health Integrated Program (MCHIP) for incorporating health equity considerations into program design. It defines health equity and describes a 6-step process and checklist to help programs 1) understand equity issues in their area, 2) identify disadvantaged groups, 3) decide on strategies, 4) set goals, 5) implement activities, and 6) monitor equity-focused indicators. Examples are provided from MCHIP country programs. The guidance was created to ensure equity is systematically addressed and improvements can be demonstrated. Attendees then participated in an exercise to apply the guidance to their own country programs.
Health Impact Assessment (HIA) is a structured and innovative process for prospectively assessing the potential impacts of a project, program or policy on the health and well-being of populations. In order to support capacity building in the field of HIA, the National Collaborating Centre for Healthy Public Policy (NCCHPP) has developed an online course on HIA. This 5-hour course is available free of charge in English and French and can be accessed at any time upon registration. It aims to familiarize participants with the process of conducting health impact assessments of projects, programs, and policies in collaboration with relevant stakeholders.
This document discusses advancing health equity in online sexual health services through GetCheckedBC, an online testing program in British Columbia. A health equity impact assessment was conducted on GetCheckedBC and identified several ways the program could potentially reinforce inequities or benefit priority groups. Recommendations include tailoring services to reach underserved populations, integrating health equity goals and measures into the program, and employing community-based research to inform provincial expansion of GetCheckedBC.
Global Fund Round 9 Phase 2 HIV Project Rivers and Bayelsa States Update ReportJohn Bako
The document provides an update report on the Society for Family Health Nigeria's Global Fund HIV Round 9 Phase 2 Project in Rivers and Bayelsa States. It summarizes the project's contributions to the states' strategic plans, including reaching over 16,500 people with HIV counseling and testing, distributing over 400,000 male condoms to most-at-risk populations, and training 1,193 peer educators and 237 teachers. It also discusses challenges faced such as frequent teacher transfers and security issues in some areas, and recommendations to address these challenges.
This document summarizes discussions from the 6th Conference on HIV prevention, treatment, and policy recommendations. It covers three tracks: 1) progress and challenges in HIV prevention, treatment, and support, 2) evidence-informed behavioral interventions, and 3) social determinants, capacity building, partnerships, and advocacy. Key accomplishments include expanded access to antiretroviral treatment, decreased treatment costs, and increased male involvement in prevention of mother-to-child transmission. However, reduced funding for prevention, high stigma, and non-communicable diseases competing for resources pose challenges. Recommendations include increasing prevention budgets, strengthening health services for all populations, and enhancing community involvement in health planning.
This document provides a guide for increasing meaningful involvement of people living with HIV/AIDS (PLHIV) in Country Coordinating Mechanisms (CCMs) that oversee Global Fund grants. It acknowledges that while PLHIV were initially excited by the Global Fund, their participation has varied in effectiveness. The guide aims to strengthen PLHIV roles through sharing best practices and universal principles of participation. It also reviews the Global Fund structure and CCM responsibilities to empower PLHIV representatives.
Transfer of the idea of the Managed Clinical Network into less advanced settingsTarry Asoka
The concept of the ‘managed clinical network’ has provoked significant attention for its promise as a means of improving services for people where their condition requires care across a range of organisations and agencies. The concept suggests a model of service organisation and governance that gives privilege to working relationships among organisations, clinical work groups, and/or individual clinicians and so promotes coordination and integration of scarce care resources, knowledge and practice. Despite repeated calls by the World Health Organisation for the adoption of managed clinical networks in developing countries, the feasibility of the network model of service delivery in this setting has not been demonstrated.
Taking the implementation of programme clusters for care and support of HIV/AIDS in Rivers State, Nigeria as a ‘more feasible’ case study, and the formation of ‘HIV/AIDS Programme clusters’ that were supported by The Global Fund as analogous to the idea of the managed clinical network; this research examined the transfer of this policy idea from where such ‘technologies’ have been trailed in practice in a number of countries affording very different institutional conditions: notably in Australia, the USA and the UK, into less advanced settings.
As suggested by the expressed ‘Theory of Change’, this study observed that the two HIV/AIDS programme clusters under review, altered networks of relationships and produced new forms of collaborative practice within these HIV/AIDS programme clusters in response to an understanding of the disease as a ‘wicked problem’, requiring collective action. Though operationally feasible, the findings of this research also indicate that, because these networks challenge existing institutional arrangements in Nigeria, the ability of collaborating partners to sustain the networks without reform within the institutional context is unclear. Further research is recommended, to explore ‘how’ and ‘why’ the idea of the managed clinical network, as an alternative means of service integration, might be implemented in an institutional context that is characterized by a mix of modes of governance (hierarchy and markets) typical of developing nations, and the possibility of ‘sustainable transfer’ into this environment.
The document provides an overview of the LIFT project, which aims to improve linkages between HIV/AIDS clinical services and economic strengthening programs. It discusses research conducted in Ethiopia and Namibia to identify challenges and promising practices around referral systems. Key findings include the importance of designated case managers, community coordination committees, and formalizing bi-directional referral processes between clinics and community organizations. The LIFT model proposes strengthening existing economic strengthening services, identifying gaps, and engaging the private sector to improve sustainable employment for clients of HIV clinical programs.
Costing human rights and gender equality commitments in the context of HIVGobernabilidad
The document discusses costing human rights and gender equality commitments in the context of HIV. It introduces the UNAIDS Human Rights Costing Tool (HRCT) which aims to estimate the resources needed to operationalize human rights commitments by conducting detailed activity-based costing of key human rights programs. The HRCT is a flexible Excel-based tool that can be used by program officers and financial officers to define programs, estimate costs, and inform strategic planning and budgeting. It has been piloted in 14 countries with lessons learned about identifying real costs of human rights programs and strengthening capacity for resource mobilization.
The document provides an overview of the new funding model being implemented by the Global Fund. It discusses key aspects such as the country dialogue process, concept note development, community system strengthening, gender equality, human rights, and CCM eligibility standards. Countries are encouraged to engage with civil society, key populations, and other stakeholders in developing national strategic plans and concept notes to apply for funding. The new process aims to provide more predictable, flexible, and streamlined funding based on country ownership and priorities.
Community Capacity Means to Improved Health Practices or an End-in-Itself_Car...CORE Group
This study examined the impact of a community capacity building intervention in Zambia on health practices. It found that:
1) Communities that received the intervention reported higher levels of community capacity compared to control communities.
2) Higher community capacity was associated with communities taking collective action to address health problems.
3) Both the intervention and higher community capacity indirectly led to improved individual health behaviors like contraceptive use and bed net use through their effect on stimulating community action.
The study demonstrated that building community capacity can be both a means to improving health, by enabling collective action, and an end in itself for social development.
Presentation given at the USAID SQALE Symposium, Bridging the Quality Gap - Strengthening Quality Improvement in Community Health Services, by Charles Mito on behalf of MEASURE Evaluation PIMA. http://usaidsqale.reachoutconsortium.org/
The HCT programme in South Africa aims to test 15 million people for HIV by June 2011 through a large-scale campaign. Nerve centres were established to coordinate the national, provincial, and local response but have faced challenges in monitoring and evaluation due to limited funding. The campaign employs multiple sectors and over 10,000 testing sites but uncertainty remains around actual results due to inconsistent data collection and reporting across sectors.
This presentation was given by Miriam Taegtmeyer at a meeting of the Overseas Development Institute on the 20 January 2016. In it she discusses the REACHOUT quality improvement approach.
The document provides an overview of the EMPHASIS project which aims to address HIV vulnerability among mobile populations in South Asia. The project will work along mobility routes from Nepal and Bangladesh to India, setting up service networks to increase access to HIV prevention, treatment, and care. In the first year, the project will focus on building knowledge about the target populations to inform the design and delivery of effective HIV services tailored to their needs and experiences of mobility.
Jennifer Mason, Senior Advisor for FP/HIV Integration for USAID's Office of Population and Reproductive Health describes the agency's approach to integrating family planning services with HIV health services and provides country examples of integration practices.
As members of the body of Christ, what is our role in fostering collaboration to increase patient access and higher quality care? Barbara Campbell, RPh, CCN, Executive Director, ReLink Global Health-The Dalton Foundation explores the experiences of establishing the Haiti Health Network, a collaboration of more than 500 healthcare providers.
The document outlines activities and priorities for FY14 and FY15 across multiple technical working groups within CORE Group. For FY14, upcoming activities include webinars, workshops, and dissemination of tools/guidance documents. FY15 priorities include expanding community case management programs, strengthening integration of health and development programs, and increasing focus on issues like maternal mental health and pediatric TB. The document provides updates on past accomplishments and outlines many proposed future activities and areas of collaboration between working groups.
The general population HIV prevalence stands at 5.1%(THMIS 2011/12) down from 18% in 1990.
HIV and STIs prevalence are also high among KP's, HIV is 31.4% while other STI has an average of 26% prevalence.
The number of KP's is not known, although there are fledgling groups of KP's which have started advocating for the Right to Health of KP's including protection against HIV infection, care and treatment to PLHIV KP's.
Sector planning-strategies-and-their-implementation-water for allAicha Chorak Franky
Here are a few key things I would consider taking forward based on the GLAAS results and discussion:
- Schedule time at our next senior management/country team meeting to review and discuss the GLAAS results for our country/countries in more depth. This will help identify strengths and gaps to inform our strategy and planning.
- Review our country strategy and annual workplans to ensure they are adequately addressing any gaps or weaknesses identified through GLAAS related to strengthening national systems. This may require revising objectives, targets or activities.
- Engage with other stakeholders like the government through our existing coordination platforms to discuss GLAAS findings and explore opportunities for collaboration to strengthen areas like policy development, planning, monitoring and finance mobil
This document summarizes LVCT Health's experience building the capacities of organizations led by people with disabilities (DPOs) in Nyanza, Kenya to improve access to sexual and reproductive health and HIV services. LVCT Health used a participatory approach to provide training, mentorship, and coaching to three DPOs over three years. As a result, the DPOs gained stable income sources, policy documents, referral systems, and the ability to engage in advocacy. The process showed that peer-led DPOs are effective, and working with them requires patience and sustained support. There is a need to better include people with disabilities in national health planning and make services more accessible and sensitive to their needs.
Practical Guidance for Incorporating Health Equity Learning_Jennifer Winestoc...CORE Group
This document outlines guidance from the Maternal and Child Health Integrated Program (MCHIP) for incorporating health equity considerations into program design. It defines health equity and describes a 6-step process and checklist to help programs 1) understand equity issues in their area, 2) identify disadvantaged groups, 3) decide on strategies, 4) set goals, 5) implement activities, and 6) monitor equity-focused indicators. Examples are provided from MCHIP country programs. The guidance was created to ensure equity is systematically addressed and improvements can be demonstrated. Attendees then participated in an exercise to apply the guidance to their own country programs.
Health Impact Assessment (HIA) is a structured and innovative process for prospectively assessing the potential impacts of a project, program or policy on the health and well-being of populations. In order to support capacity building in the field of HIA, the National Collaborating Centre for Healthy Public Policy (NCCHPP) has developed an online course on HIA. This 5-hour course is available free of charge in English and French and can be accessed at any time upon registration. It aims to familiarize participants with the process of conducting health impact assessments of projects, programs, and policies in collaboration with relevant stakeholders.
This document discusses advancing health equity in online sexual health services through GetCheckedBC, an online testing program in British Columbia. A health equity impact assessment was conducted on GetCheckedBC and identified several ways the program could potentially reinforce inequities or benefit priority groups. Recommendations include tailoring services to reach underserved populations, integrating health equity goals and measures into the program, and employing community-based research to inform provincial expansion of GetCheckedBC.
Global Fund Round 9 Phase 2 HIV Project Rivers and Bayelsa States Update ReportJohn Bako
The document provides an update report on the Society for Family Health Nigeria's Global Fund HIV Round 9 Phase 2 Project in Rivers and Bayelsa States. It summarizes the project's contributions to the states' strategic plans, including reaching over 16,500 people with HIV counseling and testing, distributing over 400,000 male condoms to most-at-risk populations, and training 1,193 peer educators and 237 teachers. It also discusses challenges faced such as frequent teacher transfers and security issues in some areas, and recommendations to address these challenges.
This document summarizes discussions from the 6th Conference on HIV prevention, treatment, and policy recommendations. It covers three tracks: 1) progress and challenges in HIV prevention, treatment, and support, 2) evidence-informed behavioral interventions, and 3) social determinants, capacity building, partnerships, and advocacy. Key accomplishments include expanded access to antiretroviral treatment, decreased treatment costs, and increased male involvement in prevention of mother-to-child transmission. However, reduced funding for prevention, high stigma, and non-communicable diseases competing for resources pose challenges. Recommendations include increasing prevention budgets, strengthening health services for all populations, and enhancing community involvement in health planning.
This document provides a guide for increasing meaningful involvement of people living with HIV/AIDS (PLHIV) in Country Coordinating Mechanisms (CCMs) that oversee Global Fund grants. It acknowledges that while PLHIV were initially excited by the Global Fund, their participation has varied in effectiveness. The guide aims to strengthen PLHIV roles through sharing best practices and universal principles of participation. It also reviews the Global Fund structure and CCM responsibilities to empower PLHIV representatives.
Transfer of the idea of the Managed Clinical Network into less advanced settingsTarry Asoka
The concept of the ‘managed clinical network’ has provoked significant attention for its promise as a means of improving services for people where their condition requires care across a range of organisations and agencies. The concept suggests a model of service organisation and governance that gives privilege to working relationships among organisations, clinical work groups, and/or individual clinicians and so promotes coordination and integration of scarce care resources, knowledge and practice. Despite repeated calls by the World Health Organisation for the adoption of managed clinical networks in developing countries, the feasibility of the network model of service delivery in this setting has not been demonstrated.
Taking the implementation of programme clusters for care and support of HIV/AIDS in Rivers State, Nigeria as a ‘more feasible’ case study, and the formation of ‘HIV/AIDS Programme clusters’ that were supported by The Global Fund as analogous to the idea of the managed clinical network; this research examined the transfer of this policy idea from where such ‘technologies’ have been trailed in practice in a number of countries affording very different institutional conditions: notably in Australia, the USA and the UK, into less advanced settings.
As suggested by the expressed ‘Theory of Change’, this study observed that the two HIV/AIDS programme clusters under review, altered networks of relationships and produced new forms of collaborative practice within these HIV/AIDS programme clusters in response to an understanding of the disease as a ‘wicked problem’, requiring collective action. Though operationally feasible, the findings of this research also indicate that, because these networks challenge existing institutional arrangements in Nigeria, the ability of collaborating partners to sustain the networks without reform within the institutional context is unclear. Further research is recommended, to explore ‘how’ and ‘why’ the idea of the managed clinical network, as an alternative means of service integration, might be implemented in an institutional context that is characterized by a mix of modes of governance (hierarchy and markets) typical of developing nations, and the possibility of ‘sustainable transfer’ into this environment.
The document provides an overview of the LIFT project, which aims to improve linkages between HIV/AIDS clinical services and economic strengthening programs. It discusses research conducted in Ethiopia and Namibia to identify challenges and promising practices around referral systems. Key findings include the importance of designated case managers, community coordination committees, and formalizing bi-directional referral processes between clinics and community organizations. The LIFT model proposes strengthening existing economic strengthening services, identifying gaps, and engaging the private sector to improve sustainable employment for clients of HIV clinical programs.
Costing human rights and gender equality commitments in the context of HIVGobernabilidad
The document discusses costing human rights and gender equality commitments in the context of HIV. It introduces the UNAIDS Human Rights Costing Tool (HRCT) which aims to estimate the resources needed to operationalize human rights commitments by conducting detailed activity-based costing of key human rights programs. The HRCT is a flexible Excel-based tool that can be used by program officers and financial officers to define programs, estimate costs, and inform strategic planning and budgeting. It has been piloted in 14 countries with lessons learned about identifying real costs of human rights programs and strengthening capacity for resource mobilization.
The document provides an overview of the new funding model being implemented by the Global Fund. It discusses key aspects such as the country dialogue process, concept note development, community system strengthening, gender equality, human rights, and CCM eligibility standards. Countries are encouraged to engage with civil society, key populations, and other stakeholders in developing national strategic plans and concept notes to apply for funding. The new process aims to provide more predictable, flexible, and streamlined funding based on country ownership and priorities.
Community Capacity Means to Improved Health Practices or an End-in-Itself_Car...CORE Group
This study examined the impact of a community capacity building intervention in Zambia on health practices. It found that:
1) Communities that received the intervention reported higher levels of community capacity compared to control communities.
2) Higher community capacity was associated with communities taking collective action to address health problems.
3) Both the intervention and higher community capacity indirectly led to improved individual health behaviors like contraceptive use and bed net use through their effect on stimulating community action.
The study demonstrated that building community capacity can be both a means to improving health, by enabling collective action, and an end in itself for social development.
Presentation given at the USAID SQALE Symposium, Bridging the Quality Gap - Strengthening Quality Improvement in Community Health Services, by Charles Mito on behalf of MEASURE Evaluation PIMA. http://usaidsqale.reachoutconsortium.org/
The HCT programme in South Africa aims to test 15 million people for HIV by June 2011 through a large-scale campaign. Nerve centres were established to coordinate the national, provincial, and local response but have faced challenges in monitoring and evaluation due to limited funding. The campaign employs multiple sectors and over 10,000 testing sites but uncertainty remains around actual results due to inconsistent data collection and reporting across sectors.
This presentation was given by Miriam Taegtmeyer at a meeting of the Overseas Development Institute on the 20 January 2016. In it she discusses the REACHOUT quality improvement approach.
The document provides an overview of the EMPHASIS project which aims to address HIV vulnerability among mobile populations in South Asia. The project will work along mobility routes from Nepal and Bangladesh to India, setting up service networks to increase access to HIV prevention, treatment, and care. In the first year, the project will focus on building knowledge about the target populations to inform the design and delivery of effective HIV services tailored to their needs and experiences of mobility.
Jennifer Mason, Senior Advisor for FP/HIV Integration for USAID's Office of Population and Reproductive Health describes the agency's approach to integrating family planning services with HIV health services and provides country examples of integration practices.
As members of the body of Christ, what is our role in fostering collaboration to increase patient access and higher quality care? Barbara Campbell, RPh, CCN, Executive Director, ReLink Global Health-The Dalton Foundation explores the experiences of establishing the Haiti Health Network, a collaboration of more than 500 healthcare providers.
The document outlines activities and priorities for FY14 and FY15 across multiple technical working groups within CORE Group. For FY14, upcoming activities include webinars, workshops, and dissemination of tools/guidance documents. FY15 priorities include expanding community case management programs, strengthening integration of health and development programs, and increasing focus on issues like maternal mental health and pediatric TB. The document provides updates on past accomplishments and outlines many proposed future activities and areas of collaboration between working groups.
Learn more about how the Regional Municipality of York explored and implemented a bylaw in their region mandating food handler certification for food premises.
This document discusses the need to build the evidence base for HIV prevention programs. It notes five key drivers for this: 1) epidemiological and biomedical developments in HIV transmission and treatment; 2) changing community and cultural expectations; 3) policy developments in preventative health and HIV; 4) debates around what constitutes valid evidence; and 5) the fact that more evidence alone is not enough without proper translation into policy and practice. It argues for collaborative, practice-based approaches to evaluation that engage communities and build capacity, in order to demonstrate program impact and improve outcomes.
Hia presentation for health disparities group revisedDanielle Aloia
A health impact assessment is a systematic process that evaluates the potential effects of proposed policies, programs, or projects on the health of populations and the distribution of effects within populations. It involves screening, scoping, assessment, recommendations, and monitoring/evaluation steps. Health impact assessments aim to promote health equity by authentically engaging stakeholders, evaluating impacts on vulnerable groups, identifying recommendations to maximize health benefits for those facing health disparities, and communicating results in culturally appropriate ways. Examples provided assessed proposed legislation to protect domestic workers in California, revisions to Minnesota school siting guidelines, and changes to a Massachusetts housing assistance program. Emerging issues discussed opportunities to further health equity as well as challenges regarding timing, stakeholders, evidence, and legal frameworks.
The document introduces the HCV HUB, a knowledge management platform created to address the global hepatitis C virus (HCV) epidemic. The HCV HUB aims to [1] collect up-to-date HCV information and resources in one centralized location, [2] connect users with the global HCV community, and [3] facilitate HCV knowledge exchange to support efforts to cure and control HCV worldwide. Content on the HCV HUB is organized and covers a range of topics including interventions, case studies, publications, and action plans. The HCV HUB is intended to be a useful resource for various stakeholders interested in improving HCV management, including policymakers, health professionals, and community organizations.
Interested in learning how to evaluate your policy influence?
Do you promote the uptake and dissemination of population health interventions? Are you interested in exploring public health–related case studies of policy influence? The Guide to Policy-Influence Evaluation can help!
This guide was developed by the Public Health Agency of Canada’s Innovation Strategy and produced by Cathexis Consulting.
How can the Guide to Policy-Influence Evaluation help you?
The Guide to Policy-Influence Evaluation was developed to help organizations use policy influence to improve the uptake and evaluation of evidence-based population health interventions. This process is divided into the four steps of evaluation planning. Each step includes two or more resources to support it. The resources are then summarized and important highlights are presented as they related to each step.
This webinar includes an overview of the Guide by its developers, followed by a presentation from a community based organization who evaluated the impact on policies within their work to promote healthier weights.
The Guide to Policy-Influence Evaluation includes three public health–related case studies:
•Healthy weights among Aboriginal children and youth
•Anti-bullying for primary schools
•Food security and healthy weights
To see the summary statement of this method developed by NCCMT, click here: http://www.nccmt.ca/resources/search/241
The National Collaborating Centre for Methods and Tools is funded by the Public Health Agency of Canada and affiliated with McMaster University. The views expressed herein do not necessarily represent the views of the Public Health Agency of Canada.
NCCMT is one of six National Collaborating Centres (NCCs) for Public Health. The Centres promote and improve the use of scientific research and other knowledge to strengthen public health practices and policies in Canada.
The document introduces the HCV HUB, a knowledge management platform created to address the global hepatitis C virus (HCV) epidemic. The HCV HUB aims to [1] collect up-to-date HCV information and resources in one centralized location, [2] connect users with the global HCV community, and [3] facilitate HCV knowledge exchange and learning from international experiences. Content is organized into tools, case studies, interventions, action plans, and publications. The HCV HUB is intended to support a variety of HCV stakeholders, including government agencies, payers, researchers, and community groups, in developing and improving HCV prevention, treatment, and control plans.
Keeping It Real:Resources for Implementing Evidence-based Public Health Progr...MargaretFarrell
Through this workshop, participants will
not only become familiar with how to use the tools they need to identity and address health outcomes, but
understand the benefits of virtual communities of practice as a means to engage researchers and practitioners around implementing cancer control programs.
will introduce participants to the Cancer Control P.L.A.N.E.T portal and the Research to Reality Community of Practice. (#NCIR2R)
Presentation given at the NATIONAL HEALTH OUTREACH CONFERENCE (#NHOC) Promoting Connections to Create Healthy Individuals, Families and Communities May 8, 2015
The document summarizes an HCV HUB, which is a knowledge management platform that centralizes up-to-date information on hepatitis C virus (HCV) from various stakeholders. The HCV HUB aims to support organizations and communities in planning and implementing HCV cure and control strategies. It allows users to collect relevant HCV publications and resources, connect with the global HCV community, and learn from other experiences. Content is organized into tools, case studies, interventions, action plans, and publications. The HCV HUB is intended to benefit various stakeholders, including patient associations for advocacy efforts.
Operational research (OR) is a process used to identify and solve health program problems through a continuous cycle of problem identification, strategy selection, strategy testing and evaluation, information dissemination, and utilization. The document discusses how OR has been used to optimize HIV interventions, understand cost-effectiveness, and improve care for vulnerable populations. Some example areas where OR has focused include prevention of mother-to-child transmission, increasing access to antiretroviral therapy, and integrating HIV/AIDS services with other health programs.
Interested in sharing best practices within your organization?
Are you engaged in creating community health status reports? Are you interested in learning about how to improve health equity? The Equity-Integrated Population Health Status Reporting Action Framework can help health professionals at all levels identify and implement manageable steps for integrating equity into existing or new public health status reporting processes. The framework is suitable for use by health/public health staff, community organizations that provide local data, and academic researchers.
This framework was developed collaboratively by the six National Collaborating Centres for Public Health, building upon earlier work by the NCC for Determinants of Health.
To see the summary statement of this tool developed by NCCMT, click here: http://www.nccmt.ca/resources/search/240
The National Collaborating Centre for Methods and Tools is funded by the Public Health Agency of Canada and affiliated with McMaster University. The views expressed herein do not necessarily represent the views of the Public Health Agency of Canada.
NCCMT is one of six National Collaborating Centres (NCCs) for Public Health. The Centres promote and improve the use of scientific research and other knowledge to strengthen public health practices and policies in Canada.
Strengthening Community Health Systems_Henry Perry_5.8.14CORE Group
This document summarizes a review of community-based approaches to improving reproductive, maternal, neonatal and child health. The review found evidence that community health workers can effectively deliver interventions like immunizations, vitamin A supplementation, and treatment of childhood illnesses. Participatory women's groups and home visits were also found to improve health outcomes. Large community health worker programs in countries like Bangladesh and Ethiopia demonstrated improved coverage and reductions in mortality. The review calls for more integrated community-based programming, strengthening of health systems, and viewing communities as partners rather than just recipients of services.
The document summarizes an HCV HUB, which is an online knowledge management platform created to address the global HCV epidemic. It collects up-to-date information and resources on HCV prevention, treatment and control from various stakeholders in one centralized location. The objective of the HCV HUB is to support users and their organizations by allowing them to collect relevant information, connect with the global HCV community, and learn from international experiences. Content is organized into tools, case studies, interventions and other resources. The HCV HUB is intended to help a wide range of stakeholders, including healthcare professionals, develop and improve HCV plans and interventions.
The document summarizes updates from the National Chlamydia Coalition meeting in 2012. It discusses:
1) Updates on NCC initiatives like mini-grants and webinars, as well as plans for a new sexual health coalition.
2) Updates from each of the NCC committees, including new resources developed and priorities for the upcoming year like updating educational materials.
3) The formation of Special Policy Groups to focus efforts on achievable policy objectives, with the first group addressing adolescent confidentiality.
CSHGP Operations Research Findings_Jennifer Weiss and Khadija Bakarr_5.8.14CORE Group
1. The Operations Research study tested an Integrated Care Group model in Burundi which achieved at least the same improvements in key health knowledge and practices as the traditional Care Group model.
2. The Integrated Care Group model was found to function as well as the traditional model in terms of volunteer attendance and household visits.
3. The Integrated Care Group model was determined to be as sustainable as the traditional model in the six months following the end of project support.
HCV HUB planning and implementation website introduction with a specific focus on the benefits provided to scientific societies. http://hcvhub.deusto.es
Engaging extension in health reform 4 16 2013Cynthia Reeves
This seminar covered Extension's involvement in health initiatives at the community level. It discussed strategic health priorities for Extension and the role of social media in outreach. The National Institute of Food and Agriculture aims to increase access to health services and clinical preventive care through Extension programs. Extension also launched a multi-state Health Insurance Literacy Initiative to educate consumers about selecting health plans under the Affordable Care Act. Connecting programs and outreach at the local level will be important for implementing health reform.
Similar to STBBI Health Equity Impact Assessment Tool (20)
Gene therapy can be broadly defined as the transfer of genetic material to cure a disease or at least to improve the clinical status of a patient.
One of the basic concepts of gene therapy is to transform viruses into genetic shuttles, which will deliver the gene of interest into the target cells.
Safe methods have been devised to do this, using several viral and non-viral vectors.
In the future, this technique may allow doctors to treat a disorder by inserting a gene into a patient's cells instead of using drugs or surgery.
The biggest hurdle faced by medical research in gene therapy is the availability of effective gene-carrying vectors that meet all of the following criteria:
Protection of transgene or genetic cargo from degradative action of systemic and endonucleases,
Delivery of genetic material to the target site, i.e., either cell cytoplasm or nucleus,
Low potential of triggering unwanted immune responses or genotoxicity,
Economical and feasible availability for patients .
Viruses are naturally evolved vehicles that efficiently transfer their genes into host cells.
Choice of viral vector is dependent on gene transfer efficiency, capacity to carry foreign genes, toxicity, stability, immune responses towards viral antigens and potential viral recombination.
There are a wide variety of vectors used to deliver DNA or oligo nucleotides into mammalian cells, either in vitro or in vivo.
The most common vector system based on retroviruses, adenoviruses, herpes simplex viruses, adeno associated viruses.
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
Discover the benefits of homeopathic medicine for irregular periods with our guide on 5 common remedies. Learn how these natural treatments can help regulate menstrual cycles and improve overall menstrual health.
Visit Us: https://drdeepikashomeopathy.com/service/irregular-periods-treatment/
PGx Analysis in VarSeq: A User’s PerspectiveGolden Helix
Since our release of the PGx capabilities in VarSeq, we’ve had a few months to gather some insights from various use cases. Some users approach PGx workflows by means of array genotyping or what seems to be a growing trend of adding the star allele calling to the existing NGS pipeline for whole genome data. Luckily, both approaches are supported with the VarSeq software platform. The genotyping method being used will also dictate what the scope of the tertiary analysis will be. For example, are your PGx reports a standalone pipeline or would your lab’s goal be to handle a dual-purpose workflow and report on PGx + Diagnostic findings.
The purpose of this webcast is to:
Discuss and demonstrate the approaches with array and NGS genotyping methods for star allele calling to prep for downstream analysis.
Following genotyping, explore alternative tertiary workflow concepts in VarSeq to handle PGx reporting.
Moreover, we will include insights users will need to consider when validating their PGx workflow for all possible star alleles and options you have for automating your PGx analysis for large number of samples. Please join us for a session dedicated to the application of star allele genotyping and subsequent PGx workflows in our VarSeq software.
Nutritional deficiency Disorder are problems in india.
It is very important to learn about Indian child's nutritional parameters as well the Disease related to alteration in their Nutrition.
- Video recording of this lecture in English language: https://youtu.be/RvdYsTzgQq8
- Video recording of this lecture in Arabic language: https://youtu.be/ECILGWtgZko
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Congestive Heart failure is caused by low cardiac output and high sympathetic discharge. Diuretics reduce preload, ACE inhibitors lower afterload, beta blockers reduce sympathetic activity, and digitalis has inotropic effects. Newer medications target vasodilation and myosin activation to improve heart efficiency while lowering energy requirements. Combination therapy, following an assessment of cardiac function and volume status, is the most effective strategy to heart failure care.
Spontaneous Bacterial Peritonitis - Pathogenesis , Clinical Features & Manage...Jim Jacob Roy
In this presentation , SBP ( spontaneous bacterial peritonitis ) , which is a common complication in patients with cirrhosis and ascites is described in detail.
The reference for this presentation is Sleisenger and Fordtran's Gastrointestinal and Liver Disease Textbook ( 11th edition ).
1. www.cpha.ca
Welcome to the CPHA Webinar
Sexually Transmitted and
Blood Born Infections (STBBIs)
Health Equity Impact
Assessment
We will be starting shortly.
To connect to the Audio portion of the
webinar:
Toll Free: 1-877-394-5901
Local (Toronto only): 416-548-6023
Access Code: 741-9512
3. www.cpha.ca
• This webinar introduces the user to the STBBI Health Equity Impact
Assessment Tool (HEIA) developed by the Canadian Public Health
Association (CPHA)
• This tool was developed as part of the larger project “ Core Competencies
for STBBI Prevention”
• Other Webinars are available to access the STBBI Core Competencies and
associated tools
About this webinar
4. www.cpha.ca
Overview
• Project Overview and STBBIs in Canada
• Overview of Health Equity
• Development Process
• STBBI HEIA Tool
• Factors that Impact Vulnerability
• Example Scenario
• Tools
• Other resources
5. www.cpha.ca
STBBIs in Canada
• HIV is different than in most countries - in Canada HIV is not a generalized
epidemic; rather it is concentrated in specific populations
• HIV rates have been collected since 1985 with significant fluctuations but
since 2008 rates have steadily been decreasing in the general population
• In 2008 ; 2,619 positive tests were recorded compared to 2012 only 2,062
were reported (PHAC, 2012)
• Conversely rates in certain populations and regions are rising (ie. First
Nations in SK. People who inject drugs in Ottawa)
• While HIV rates are decreasing, sexually transmitted infection data shows
that rates have been increasing since 1997 ; chlamydia, gonorrhea and
syphilis (PHAC, 2009)
• Data collection for HIV in most regions includes a variety of demographic
questions this is not the case for other STBBIs making it difficult to
develop prevention strategies for targeted populations and regions
6. www.cpha.ca
STBBIs in Canada
• In Canada, reported rates of chlamydia, gonorrhea and infectious syphilis
have increased significantly among middle-aged adults (40-59 years) over
the past decade
• The lack of awareness about sexually transmitted infections(STIs) and their
prevention may be contributing to the increasing reported rates
• Chlamydia continues to be the most commonly reported STI in Canada.
Reported rates of chlamydia infections have increased by 71.3% since 2000
• Example – Alberta - Chlamydia rates increased by 207% from 1999 to
2009, with over 13,000 cases reported in 2009. Many of those cases
occurred in females with many younger than 25 years of age
• Example - Ottawa - The incidence of chlamydia has more than doubled over
10 years in Ottawa and Ontario. Between 2009 and 2010 alone, the number
of cases increased by 14% (from 2023 to 2314). Young people 15–29 years
had the highest incidence of infection, particularly young women, who
accounted for 54% (n=1242) of all reported cases in 2010
7. www.cpha.ca
Project Overview
• In 2010 CPHA undertook a project: Preparing Health for New HIV
Prevention Technologies: A Roadmap for Comprehensive Action in Canada
• This project at looked public health's’ knowledge, information needs roles,
opportunities, challenges and capacity to introduce and deliver NPTs in
Canada
• The project uncovered that front-line providers require and recommended
more training and ongoing opportunities to address STBBIs
• This in turn led to an online course – with an attempt to link the content to
the original Public Health Core Competencies
• Individual and organizational capacity to deliver STBBI prevention
interventions in Canada to priority populations remains a challenge
8. www.cpha.ca
Project overview
• Effective STBBI prevention requires engagement of many disciplines and
sectors (public health, social services, mental health services, police
services, social housing, youth services, shelters, etc.)
• This led to the project “Developing STBBI Core Competencies”
• A number of prevention tools currently exist but the STBBI Core
Competencies are unique as they are infection specific not profession
specific as other competencies are
• During the course of the project no other such STBBI have been uncovered
9. www.cpha.ca
Project overview
• Similarly, existing Health Equity Impact Assessments (HEIAs) are generic
meant to be applied to any proposed policy, legislation or initiative and there
was a need to develop a targeted tool for organizations
• While many populations may face challenges or barriers to health some
groups are significantly impacted by systemic factors that have a deeper
impact on their opportunities to achieve equitable health and as a
consequence may increase risk of STBBIs
• The STBBI Health Equity Impact Assessment Tool has been designed as a
practical tool with the goal of helping to ensure that front-line initiatives do
their utmost to prevent any increase in existing health inequities and
vulnerability to HIV/STBBIs
10. www.cpha.ca
Health Equity
Health equity has been defined as:
“ A means to reducing barriers in access to quality health care for all by
addressing the health needs of people along the social gradient, including
those most health disadvantaged…Health inequities or disparities are
differences in heath outcomes that are avoidable, unfair and are related to
social inequality and marginalization. Roots of disparities lie in the broader
social and economic inequality and exclusion…”
• Most equity or health equity approaches to health take into account the fact
that social determinants of health (SDoH) have an impact on ones’ health
and well being
• What if anything is different for sexual health?
11. www.cpha.ca
Approach:
“STBBIs for Core Competencies” resulted in the development of three tools:
1) STBBI Core Competencies
2) STBBI Health Equity Impact Assessment
3) Factors that Impact Vulnerability
• CPHA worked with communities across the country and a national
reference group to help inform the development of the tools
• Core Competencies focus on individual skills ultimately enhancing
organizational strengths; the STBBI HEIA is a practical organizational tool to
embed equity into planning and programming and prevent an increase of
existing inequities in populations that may be at risk of infections
• FIV can be used as a stand alone document that provides examples of
factors that impact STBBI vulnerability but is to be the companion resource
for the HEIA to assess a proposed initiative
12. www.cpha.ca
Approach continued
• An extensive literature was conducted to identify existing Health Equity
tools, equity and health equity literature as well as participation in health
equity webinars and attendance at the International Health Equity
Conference in Quebec City in 2012
• Upon final review of the collected information ,for purposes of the project
the most relevant tool to be used as a starting point was the Ontario Ministry
of Health and Long Term Care’s Health Equity Impact Assessment Tool
• The initial STBBI HEIA was loosely predicated on the Ontario tool, literature
review and combination of existing tools
• Initial edits were completed by an external editor and guided by project staff
13. www.cpha.ca
Approach continued
The initial STBBI HEIA was introduced during community consultations and a
table top exercise was conducted using a hypothetical proposed policy,
program or service ( initiative)
The goal of the exercise was to determine if organizations:
- Found it useful
- Found it was relevant
- Found it user friendly
The revised STBBI Tool was work shopped:
- At the CPHA Conference
- In a community partner organization with staff
Further iterations of the Tool occurred and the Tool was translated for plain
language and a final external edit occurred
14. www.cpha.ca
Responses
Initial response was favourable and organizations and individuals felt that it was
a Tool that could be incorporated into their work
Examples of use:
- work planning ;
- evaluation and assessment plans to strengthen program and policy
development;
- guide strategic planning and strengthen internal capacity through team
building;
- Assist to develop and strengthen external community partnerships
Clarifications:
- It is not mandatory
- It is to be used by organizations and individuals and adapted as necessary
15. www.cpha.ca
STBBI HEIA Tool
For Today’s webinar we are highlighting the key sections of the STBBI HEIA
The complete STBBI HEIA Tool consists of:
- Introduction and background of Health Equity
- HEIA principles
- STBBI HEIA and Objectives
- Factors that Impact Vulnerability (FIV)
- Populations and Intersections
- Detailed instructions to complete the STBBI HEIA, an adaptable template
- An example scenario using FIV
- Other Resources
17. www.cpha.ca
Types of HEIA’s
There are three main levels of assessment
1. Rapid or desk top HEIA
2. Standard HEIA
3. Comprehensive HEIA
Most assessments typically fall between the rapid or desk-top level and the
standard level. The organization needs to determine what type will best suit
their needs.
18. www.cpha.ca
STBBI HEIA Main Objectives
• Support an organization’s assessment and decision-making during the
development of STBBI prevention initiatives
• The STBBI HEIA is a practical organizational tool to embed equity into
planning and programming
• The HEIA STBBI can assist to prevent an increase of existing inequities in
populations that may be at risk of infections
• The STBBI HEIA can assist organizations to develop equitable prevention
programs, services or initiatives
• The STBBI HEIA can support organizations to identify individuals that may
be hidden in their communities
19. www.cpha.ca
• The STBBI HEIA provides specific examples of factors that impact one’s
general risk of infection and also in specific populations
• Lastly it can strengthen future work around the factors that may impact
vulnerability to STBBIs
20. www.cpha.ca
Priority populations and
Intersections
• There are 8 priority populations considered most at risk of infection to HIV:
Aboriginal peoples (First Nations, Inuit, and Métis peoples)
Gay, bi sexual, 2-spirit, and other men who have sex with men
People who use substances including injection drugs (modified from people
who use injection drugs)
People who have been or are currently in prison ( modified from People in
prison)
Youth at risk
Women at risk
People from African, Caribbean, Black (ACB) countries, newcomers and
other countries where HIV is endemic (modified from people from countries
where HIV is endemic)
People living with HIV/AIDS
Other population groups, such as those without legal status in Canada or
without health insurance; people without a family doctor.
21. www.cpha.ca
Populations continued
• While it is important to be aware of the identified populations that are at
increased risk of STBBIs it is also important for organizations to not feel
constrained or that they are prescribed
• The suggested populations are a starting point from which to examine their
community and may raise awareness of people who may be living in the
community that they were unaware of
• Organizations can use the STBBI HEIA to identify who may be most at risk
and how to tailor the initiative to best address the risks or vulnerabilities of
people who may be most impacted by factors that may increase their risk
• It is important to note that identifying other groups that may be impacted
does not mean that an organization should serve all groups; it is to be
aware for the potential of impacts within a population that they did not intend
22. www.cpha.ca
Factors that Impact Vulnerability
(FIV)
• Most HEIA’s examine communities through a DoH lens
• While many approaches to STBBI prevention are built on a SDoH approach
and is useful many of these tools look at how factors affect overall health
and well-being and not their unique impact on risk of STBBIs
• In the course of this project Factors that Impact Vulnerability specific to
STBBI were identified, they are an evolution of the SDoH
• Overarching FIV have been identified that impact all populations and have
been further refined to specific populations
• The list is a starting point and not meant to be exhaustive or definitive but to
be used as companion resource to conduct assessing a proposed initiative
24. www.cpha.ca
Examples of some overarching FIV that are applicable to all
populations
- Culture and faith affect a person’s
decisions around prevention, medical
care, treatment and intervention
- Distrust of systems affects individual
decisions to access health services,
sexual health services and testing
- Poor mental health can influence an
individual’s decision to participate in
high-risk activities such as substance
use
- Attitudes towards sexual and personal
practices inform discussions between
a service provider and service user
- Perceptions about who is at risk of
STBBIs may have an impact on
information provided by service
providers and risk triage in the health
care system
- Lateral violence and internalized
homophobia may influence a person’s
risk-taking behaviours and how they
use community supports
- Experiences of violence and trauma
can be linked to risk-taking behaviours
(Some populations experience higher
rates of violence, such as First
Nations, Inuit and Metis, refugee
women, people with disabilities, sex
workers, LBGTQ people)
25. www.cpha.ca
STBBI HEIA at a glance
1. Scoping
a) Populations
b) Factors that Impact Vulnerability
2. Unintended Impacts
a) Positive
b) Negative
3. Mitigation
4. Monitoring
5. Dissemination
27. www.cpha.ca
Example Scenario
• In a small to medium sized coastal town the
local AIDS service organization administers
and delivers the STBBI programs, services
and prevention activities in the community
• Local employment is limited and many
people fly to the oil patch in Alberta for term
work; typically two weeks in two weeks out
• Recently the ASO has seen a significant
increase of male clients who have tested
positive for an STBBI
• Some men have disclosed that although in
hetero sexual relationships; they have had
sex with other men, or with sex trade
workers while away and not always
practiced safer sex
• Staff are concerned about the rising rates
and want to determine how to reduce rates
and raise awareness in the community
about risk
• In the past poster campaigns have worked
targeting gay men; on buses, storefronts
and tv ads. Primarily promoting condom use
• The ASO has decided that since it worked in
the past it may again and decide to re
launch and target hetero men between 25
and 55
28. www.cpha.ca
Scoping
1 a) Populations
1. Male oil patch workers
2. Spouses, monogamous partners
3. LGBQQT
4. Women at risk
5. Youth
1b) Factors that Impact Vulnerability
-Lack of confidentiality ( small
community)
-Possibility of increased use of
substances (being far away and
isolated from family, friends, new
opportunities not available at home)
-Unaware of sexual partners’
health/history
-Spouses/partners: unaware of risk that
may be present and continue to
participate in barrierless sexual activity
-LGBQQT: marginalized, unaware of
risks
-Women: unaware of risk, power
dynamics
-Youth: unaware of risk
29. www.cpha.ca
Unintended Impacts
Remember these can also be neutral and more information may be needed
Positive
Workers: none
Spouses/sexual partners: none
LGBQQT: none
Women: none
Youth :none
Negative
Workers: Possibly fear of stigma of testing
positive, fear of disclosing to partner(s) as
a result will not get tested, fear of
ramifications for relationships
Spouses/sexual partners: possible
increase of risk
LGBQQT: May feel further isolated in the
community, uncomfortable accessing
services or testing at the ASO due to
hetero male focus
Women: further false sense of security;
campaign doesn’t resonate
Youth: Lack of awareness
30. www.cpha.ca
Mitigation
• Engage members of the other identified populations to design a campaign
that they feel would be relevant and effective
• Focus groups, interviews with existing clients are a few examples of
gathering feedback
• Incorporate (if feasible) recommendations
31. www.cpha.ca
Monitoring examples
The organization can:
• Use client surveys or questionnaires with members of priority populations
and those impacted by the initiative
• Rates of new STBBIs
• Process evaluation to ensure that frontline service providers, developers,
planners, and decision-makers are integrating equity and the FIV into their
processes and client interactions
• Focus groups or interviews with affected populations to see if their
vulnerability has increased or decreased since the implementation of the
initiative.
32. www.cpha.ca
Dissemination examples
• Present a case study at a conference, In a webinar or through another
media vehicle
• Do a literature review or evidence summary
• Summarize your results for other frontline organizations in your community
• Lead a workshop or other professional development activity based on your
experience within your organization and with community partners (lunch and
learn)
• Post the results of your STBBI HEIA on your website
33. www.cpha.ca
Other HEIA Resources
• Equity Lens in Public Health: Health Equity Tools 2013. Victoria, BC: University of
Victoria. Available from www.uvic.ca/elph
• Health Equity On-Line Course:
http://knowledgex.camh.net/health_equity/Pages/healthEquityImpactAssessment%28
HEIA%29OnlineCourse.aspx
• National Collaborating Centre for Determinants of Health: www.nccdh.ca
• Ontario Ministry of Health and Long Term Care; Health Equity Tool:
www.health.gov.on.ca/pro/programs/heia
• Wellesley Institute: www.wellesleyinstitute.com
The above links are examples of some Health Equity Tools available in Canada