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The new Consolidated guidelines on person-centred HIV strategic information: strengthening routine data for impact 1 aim to help countries improve how routine patient data are collected, analysed and used. They propose a minimum dataset that captures key events in an individual’s interaction with the health system, put forward priority indicators for monitoring a person’s health, and make key recommendations for data systems and data use. This policy brief summarizes the WHO guidance on digital health data in HIV services. The guidance covers several areas that are acutely important for transitioning from paper-based to digital systems while improving patient outcomes: interoperability, unique identifiers (UIDs) and privacy, security and data access and control.
Sexually transmitted infections (STIs), viral hepatitis and cervical cancer are important concerns for any country implementing HIV programmes because of their shared modes of transmission, their contribution to the risk of acquiring HIV and their substantial burden. Interventions to prevent, diagnose and treat these infections are often delivered through services integrated with or closely linked to HIV services. Collecting data on the diagnosis and treatment of related infections will help strengthen the provision of HIV prevention and treatment services and improve the health of people living with HIV and those at risk of HIV infection. Incorporating individual-level data on HIV-related infections into HIV surveillance is a new area covered in the 2022 World Health Organization Consolidated guidelines on person-centred HIV strategic information: strengthening routine data for impact and is summarized in this policy brief.
Measuring HIV prevention programmes against health outcomes (such as individuals remaining HIV-negative or new HIV infections) can be challenging. This is because HIV prevention interventions can be started and stopped according to an individual’s need. Therefore, as with all other areas of the HIV response, data from multiple sources are necessary to obtain a full picture of HIV prevention service availability, access and coverage. Recent WHO guidelines focus on using routine programmatic data to track the delivery and potential impact of HIV prevention services. Routine programmatic data from prevention services also can be used to identify individuals who may be at elevated risk of HIV acquisition and so may benefit most from prevention interventions. In addition, this data can be used to follow up on whether interventions were received, and to identify and address potential barriers to accessing these services.
These consolidated guidelines are aimed at supporting the generation of responsive person-centred data from routine national health management information systems across the HIV cascade, from prevention, testing and treatment to longer-term health care. They build upon the 2017 Consolidated guidelines on person-centred HIV patient monitoring and case surveillance, which describe information that should be collected in primary HIV patient monitoring tools, and the 2020 Consolidated HIV strategic information guidelines, which cover aggregate indicators for managing and monitoring programmes. The purpose of this guideline consolidation is to provide the recommended data elements, indicators and guidance on data systems and their use across the spectrum of health sector HIV services in one place. This document focuses on strengthening the analysis and use of routine data at each stage of the cascade and emphasizes?/addresses? person-centred HIV prevention, testing and treatment, integration of HIV-related infections, the use of routine surveillance data to measure impact, and the development and use of digital health data systems and their governance. It also identifies the gaps and limitations in these data, and the need for strengthening the use of data in all HIV-related strategic information, including population-based surveys, modelling, community-led monitoring and other sources.
This policy brief provides an overview of the complexities and challenges of people re-engaging in HIV treatment services. It highlights person-centred interventions that address the reasons for disengagement, the importance of providing support at re-engagement tailored to individual needs and country examples of tracing and re-engagement interventions. The brief summarizes WHO guidance and emphasizes the importance of implementing relevant recommendations to support adherence, continuous engagement, tracing and sustained re-engagement. This brief aims to assist health policy-makers, health ministries, practitioners, implementers and communities to improve understanding of the various challenges and solutions for re-engaging individuals to support better health outcomes. It provides guidance on supporting people living with HIV to sustain re-engagement without further interruptions in treatment and care. The goal is to reduce HIV-related morbidity and mortality, prevent new infections and the risk of drug resistance.
Digital Adaptation Kits (DAKs) are part of WHO’s SMART guidelines initiative. This aims to ensure that the content of WHO’s evidence-based guidelines is accurately reflected in the digital systems being used at country level. The DAKs provide software-neutral, operational, and structured documentation based on WHO recommendations related to clinical care, health systems and use of data, to systematically and transparently inform the design of digital systems. Standard components of each DAK include: (1) linked health interventions and recommendations; (2) user personas; (3) user scenarios; (4) business processes and workflows; (5) core data elements mapped to standard terminology codes (e.g. the international classification of diseases); (6) decision support; (7) programme indicators; and (8) functional and non-functional requirements.
WHO's pre-exposure prophylaxis (PrEP) for HIV infection implementation tool contains modules for a range of stakeholders to support them in the consideration, planning, introduction, implementation and roll-out of PrEP services. The modules can be used on their own or in combination. In addition, there is a module for individuals interested in or already taking oral PrEP. The STI integration module compiles existing WHO recommendations, systematic scientific literature reviews and other relevant publications to provide suggested implementation approaches. It is the product of collaboration among many experts, community organizations and networks, providers, implementers, researchers and partners from all regions. The STI integration module is divided into 2 parts: the first focuses on programme managers and other decision-makers, and the second on health care workers. People who use PrEP will also benefit from it.
The 2030 health-related Sustainable Development Goals call on countries to end AIDS as a public health threat and also to achieve universal health coverage. The World Health Organization (WHO) promotes primary health care (PHC) as the key mechanism for achieving universal health coverage, and the PHC approach is also essential for ending AIDS and reaching other Sustainable Development Goal targets. This publication helps decision-makers to consider and optimize the synergies between existing and future assets and investments intended for both PHC and disease-specific responses, including HIV.