Improving the Local Responses to HIV/Aids in Africa : Gaoua District, a case study of Burkina Faso

Pervilhac C. Improving the Local Responses to HIV/Aids in Africa : Gaoua District, a case study of Burkina Faso. Bielefeld (Germany): Bielefeld University; 2000.This thesis reports on a process of developing a new approach called the "Local Responses to HIV/Aids" undertaken in Gaoua District, Burkina Faso, between 1997 and 2000. It focuses on how communities, and organisations from the public and other sectors (voluntary, non and for profit, Churches) can develop more effective responses to HIV/Aids in their settings. The study described in this thesis aims: first, to improve the knowledge and gaps of how to plan and implement HIV/Aids strategies in rural settings in Africa by testing an approach called the Local Responses; second, to document critically a three years process, including some early results. The research objectives were: - first, to develop a rapid appraisal method which can be a resource for district and communities to circumscribe their needs in relation to HIV/Aids, - second, to carry out situation analyses at the community and district levels, - third, to apply the findings to improve responses, and - finally, to assess the results, including the lessons learnt from using this approach for national and international implications. The method used is based on health systems research with a pre-experimental before and after prospective intervention study. The study gives evidence of the importance of carrying out situation analyses for HIV/Aids (baseline, 1997) both at the community and district levels. Based on the findings of the analyses a consensus-building was reached on a common vision to address the epidemic with all key partners from the District, including community representatives. In complement to the existing prevention strategies, the much needed care and counselling and psycho-social support components were identified as neglected up to now, and future priority areas. I document the development of a new organisational tool called the Rapid Organisational Review (ROR). Finally, despite the strengths of this approach, the applications and limitations are presented using the case of migrants as a specific vulnerable group. Six months of implementation of the Local Responses (2nd semester 1999) are sufficient to document already substantial results: - The partnerships of non-health public sectors (i.e. Education, Agriculture etc.) and non-governmental partners (i.e. Churches, traditional authorities), and local Associations (Community-Based Organisations of different nature) have increased tremendously. - Some vulnerable groups (e.g. youth, prisoners) are now addressed specifically. - Geographic coverage has increased in the District, both in towns and rural areas. - A massive number of agents of change have been trained for some in HIV prevention from the different local Associations, and others in care and counselling. - The District of Gaoua and Poni Province have now a locally owned Technical Committee and Provincial Committee who co-ordinate the process locally. The study reports on some of the national and international positive direct benefits of the "Local Responses" as well. The study concludes that despite its positive overall outcomes, and its potential in the decades ahead, many issues related to methods used for Local Responses, to the policies, and to the research still need to be addressed in order for this approach to become more broadly known, credible, and sustainable

Social sciences and social justice in the design, implementation and evaluation of measures against COVID-19 - the case study of France in 2020

The social impact of the COVID-19 pandemic has been profound. This study uses France as a case study to analyze the role of social sciences in the COVID-19 response from March 2020 to February 2021. France’s national evaluation reports as well as other secondary sources were used to examine five social science aspects: (i) Basic public health measures in response to COVID-19, (ii) mental health, and cross-sectoral issues in social justice, such as (iii) communication, (iv) civil society and community involvement in decision-making and (v) inequities. Findings indicate poor consideration of inequities in the conception of basic measures such as wearing facemasks, hand hygiene, and social distancing, especially for vulnerable populations, while social components such as mental health, communication, and community engagement are lacking in the evaluation of France's COVID-19 response. Pandemic responses and evaluations of interventions must integrate social science aspects. To this effect, practical recommendations with policy implications are provided to pave the way toward social justice

Using HIV surveillance data: recent experiences and avenues for the future.

HIV surveillance systems provide information that is crucial to our understanding of epidemic dynamics among different populations in different settings. Surveillance data are also used for advocacy, to inform policies and programming, and for monitoring. Multiple data sources may be used and will expand in the future as service statistics from prevention and treatment programmes become available. Important and new priorities in HIV surveillance data use at the national and local levels can build on past experience with surveillance reports, national estimates, advocacy materials, and communications to the media. A new framework, integrated analysis of data from expanded surveillance systems and other sources, is proposed to inform improved programming. The approach allows making effective programme choices, based on the analysis of biological and behavioral data and the coverage of interventions in an integrated fashion. The comparison of surveillance data with financial data provides added insights in the adequacy of the response. These findings and experiences set a new agenda for technical and structural directions to improve data use in countries

TB and HIV co-infection rates, coverage of TB/HIV interventions, according to NTCP registry (A) and TB notifications (B).

<p>TB and HIV co-infection rates, coverage of TB/HIV interventions, according to NTCP registry (A) and TB notifications (B).</p

Case fatality rates among in-patients according to hospital cause-of-death coding registered in the health management information system, in relation to Spectrum-estimated AIDS deaths, for (A) adults (aged 15+) and (B) children (aged 0-14) [32].

<p>Case fatality rates among in-patients according to hospital cause-of-death coding registered in the health management information system, in relation to Spectrum-estimated AIDS deaths, for (A) adults (aged 15+) and (B) children (aged 0-14) [32].</p

HIV prevalence and incidence over time.

<p>HIV prevalence and incidence over time.</p

Population standardized number of hospital admissions for (A) females and (B) males aged 15-49 and population standardized number of hospital deaths for (C) females and (D) males aged 15-49.

<p>Population standardized number of hospital admissions for (A) females and (B) males aged 15-49 and population standardized number of hospital deaths for (C) females and (D) males aged 15-49.</p