Maternal, newborn and children health

Strengthening Paediatric TB and HIV Case Finding at the Frontline: TB/HIV Integrated Community Case Management (iCCM)

Community and primary health facility platforms have been recognized as important, but under-utilized entry points to address the large prevention, case detection and treatment gaps faced by young children with TB and/or HIV. In 2014, WHO and UNICEF revised community health worker packages for integrated community case management (iCCM) targeting children under five years of age, to include screening and referral for TB and HIV (TB/HIV iCCM). As part of an integrated, child-centered approach, TB/HIV iCCM is recommended for use in high TB and HIV burden settings.

Developed by UNICEF and Save the Children, Lessons from the Field (Uganda, Nigeria, Malawi) and Guidance (under development) are available for download.

Going the 'Last Mile' to EMTCT: A road map for ending the HIV epidemic in children

 

The 'Last Mile' road map draws on the latest scientific research and programmatic evidence to describe and recommend strategies to achieve the elimination of mother-to-child transmission of HIV (EMTCT). It includes a synthesis of evidence and country experiences for reaching EMTCT and recommends clear strategies that can improve the coverage, effectiveness and quality of national programmes for the prevention of mother-to-child transmission (PMTCT). The goal of this document is to provide guidelines for coordinated action so that national programmes address local priority areas to achieve EMTCT in an effective, people-centred, efficient and directed manner.

This document was conceptualized by the United Nations Children’s Fund (UNICEF) and partners including the Start Free working group, the Joint United Nations Programme for HIV/AIDS (UNAIDS) and the World Health Organization (WHO), and it was validated by ministries of health of Botswana, Malawi, Seychelles, Uganda, Zambia and Zimbabwe.

 

 

Advocacy Brief on Breastfeeding and HIV

Led by UNICEF and WHO, the Global Breastfeeding Collective is a partnership of more than 20 prominent international agencies calling on donors, policymakers, philanthropists and civil society to increase investment in breastfeeding worldwide. The Collective’s vision is a world in which all mothers have the technical, financial, emotional and public support they need to breastfeed. The Collective advocates for smart investments in breastfeeding programmes, assists policymakers and NGOs in implementing solutions, and galvanizes support to get real results to increase rates of breastfeeding, thereby benefiting mothers, children and nations.

Download the advocacy brief on breastfeeding and HIV above. Learn more at unicef.org/breastfeeding.

 

CSWG Policy Brief: Preventing and treating tuberculosis among children living with HIV

Tuberculosis (TB) is a major contributor to morbidity and mortality in children living with HIV (CLHIV), particularly in TB endemic settings. TB in CLHIV is a
preventable and treatable disease. WHO recommends a cascade of TB services for all CLHIV that begins with routine screening for TB symptoms and/or recent contact with an infectious TB case. It would end with either; 1) diagnosis of active TB disease and prompt initiation of TB treatment, or 2) exclusion of active TB disease and prompt initiation of TB preventive therapy (TPT). Prompt, appropriate treatment for active TB disease is effective in CLHIV.

Similarly, TPT (such as isoniazid preventive therapy) is effective in preventing TB disease and reducing mortality in CLHIV. Effectiveness of both TPT and TB treatment is maximized when CLHIV receive early antiretroviral therapy (ART) to manage HIV infection. However, implementation of these evidence-based interventions to treat and prevent TB in CLHIV remains poor.

This is part of a series of 12 policy briefs by the Child Survival Working Group on scaling up key interventions for children and adolescents living with HIV. Learn more.

Approaching 2020: Scaling up key interventions for children and adolescents living with HIV

Urgent and ambitious 2020 global targets are on the horizon, yet there has been insufficient progress in paediatric and adolescent HIV to date. Scaling up HIV services for all children and adolescents is needed, in alignment with the UNAIDS super-fast-track framework. It’s time to make sure that nobody is left behind.

This series of 12 policy briefs by the Child Survival Working Group (CSWG) looks at scaling up key interventions for children and adolescents living with HIV. They present evidence, policy and monitoring considerations, implementation guidance and tools necessary to scale up 12 key interventions which have proven successful in identifying, linking and supporting children and adolescents to access and remain in quality care and treatment.

They are designed for program managers in government and civil society programs, particularly at country-level, and provide practical information and direction.

Catalysing Paediatric HIV Early Diagnosis and Treatment within West and Central Africa Country Catch-up Plans: Report of the meeting at ICASA 2017 and Agenda for Action

The West and Central Africa Catch-up Plan provides a framework for political advocacy and accelerated action for countries to adapt and scale up effective approaches and innovations that will reduce inequity in access to HIV treatment. Twelve countries have adapted this regional initiative to their national contexts and developed country catch-up plans, with the support of the World Health Organization (WHO), UNAIDS and UNICEF.

At the 19th International Conference on AIDS and STIs in Africa (ICASA), country representatives and partners took part in a meeting convened by UNICEF and UNAIDS to reflect on the shortfalls within West and Central Africa country catch-up plans and to agree on ways to sharpen acceleration strategies and interventions that will increase access to paediatric ART.

The meeting at ICASA had three high-level strategic objectives:

  1. Call greater attention to the gap in paediatric HIV testing, including EID, and paediatric treatment within the West and Central African country catch-up plans
  2. Define the priority actions for children in country catch-up plans in 2018, with a focus on: (a) expanding access to paediatric HIV testing through improved EID and rapid testing at other entry points; (b) improving immediate linkages to care and treatment; and (c) task-shifting to enable nurses within maternal, neonatal and child health facilities to treat children
  3. Galvanize partnerships in support of country catch-up plans

More information can be found in this meeting report. 

HEI Toolkit: DBS Job Aids for Clinic

CDC-Atlanta Maternal Child HIV Branch and International Lab Branch, in collaboration with partners, have developed tools to support health care workers and laboratorians to provide services to HIV-exposed infants, including infant virologic testing.

DBS Job Aids for the Clinic: DBS collection, drying, and packaging

Intended audience:
Health care workers who collect specimens for EID on dried blood spots, dry and package specimens for transport.

Summary:
These are visual job aids that are a simplified version of the content provided in the EID video. They cover DBS collection, drying and packaging in the health clinic. They may be displayed on the wall in a health centre for easy reference.

HEI Toolkit: Care of the HIV-Exposed Infant Flipchart

CDC-Atlanta Maternal Child HIV Branch and International Lab Branch, in collaboration with partners, have developed tools to support health care workers and laboratorians to provide services to HIV-exposed infants, including infant virologic testing.

Care of the HIV-Exposed Infant Flipchart

Intended audience:
Health care workers or lay health workers who counsel the caregivers of HEIs.

Summary:
The purpose of this flipchart is to facilitate comprehensive, high quality counseling about the care needs of mothers and HIV-exposed infants to prevent vertical HIV transmission and improve infant health.  The flipchart addresses the importance of maternal health and ART adherence, as well as care and testing for the HIV-exposed infant until the infant’s final HIV diagnosis after the end of breastfeeding.

This flipchart should be printed in large format (A3 or similar), spiral bound and laminated for durable use in health clinics. There are 12 counseling cards total – each card has one side with images for the mother/caregiver and the other side with notes for the counsellor.

Topics include: basics of vertical HIV transmission, maternal health during pregnancy and breastfeeding, safe delivery, infant testing, infant medications – cotrimoxazole and ARV prophylaxis, routine infant care -- growth monitoring and immunizations, infant feeding, family planning, signs of acute child illness, and planning for mother and infant follow up.