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This publication summarizes the approach proposed by WHO to collect, analyse, report, disseminate and use strategic information on viral hepatitis at the subnational, national and global levels. These guidelines strengthen person-centred monitoring – with a priority for indicators that support person-centred health services, the core prevention, diagnosis and treatment interventions. The guidelines describe the use of strategic information at various stages of the response in the context of strengthening broader health information systems. Strategic information can be defined as data collected at all service delivery and administrative levels to inform policy and programme decisions. The guidelines recommends the stepwise guidance to build country health information systems so countries use data to strengthen the scaling up of viral hepatitis programmes. The key new additions to the guidelines are: - an updated strategic information framework for chronic viral hepatitis B & C; - a new section on person-centred data monitoring for chronic viral hepatitis B & C; - a stepwise recommendation for strengthening country surveillance for viral hepatitis; and - consolidated metadata tables for viral hepatitis indicators.
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.
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.
The Consolidated guidelines on HIV, viral hepatitis and STI prevention, diagnosis, treatment and care for key populations outline a public health response for five key populations (men who have sex with men, trans and gender diverse people, sex workers, people who inject drugs and people in prisons and other closed settings). They present and discuss new recommendations and consolidate a range of recommendations and guidance from current WHO guidelines. Particularly for key populations, social, legal, structural and other contextual factors both increase vulnerability to HIV, viral hepatitis and STIs and obstruct access to health and other essential services. These guidelines highlight the critical importance of addressing structural barriers in all settings as a priority. In most countries, inadequate coverage and poor quality of services for key populations continue to undermine responses to HIV, viral hepatitis and STIs. All countries should prioritise reaching key populations and supporting key population communities to lead the response and provide equitable, accessible and acceptable services. In most countries, inadequate coverage and poor quality of services for key populations continue to undermine responses to HIV, viral hepatitis and STIs. All countries should prioritise reaching these key populations and supporting key population communities to lead the response and provide equitable, accessible and acceptable services to these groups.
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.
This is the first consolidated WHO report on viral hepatitis epidemiology, service coverage and product access, with improved data for action. This report presents the latest estimates on the disease burden and the coverage of essential viral hepatitis services from 187 countries across the world. The report also updates progress made since 2019 in improving access to health products for both hepatitis B and C in low- and middle-income countries, with information from 38 countries that together comprise nearly 80% of global viral hepatitis infections and deaths. The report provides a regional perspective, analysing the barriers and opportunities for countries in each of the 6 WHO regions to expand access to health products for viral hepatitis. It presents actions for countries and stakeholders to accelerate the scaling up of effective viral hepatitis interventions within a public health approach.
This report is the first of a series of biennial progress reports on the implementation of the Global health sector strategies on HIV, viral hepatitis and sexually transmitted infections for the period 2022–2030. It draws attention to areas of progress and gaps in preparation for the mid-term review of the strategies in 2026.
These recommendations include approaches for differentiated service delivery (DSD) of antiretroviral therapy (ART) that are less intensive and provide person-centred services to improve both quality and retention in care. As a result many countries have introduced or are scaling up DSD ART models. Currently, countries and partners are seeking to strengthen monitoring of differentiated ART service delivery to address implementation gaps and crucially improve patient outcomes.
To ensure that countries can effectively benefit from digital health investments, “digital adaptation kits” (DAKs) are designed to facilitate the accurate reflection of WHO’s clinical, public health and data use guidelines in the digital systems that countries are adopting. DAKs are operational, software-neutral, standardized documentations that distil clinical, public health and data use guidance into a format that can be transparently incorporated into digital systems. For this particular DAK, the operational requirements are based on systems that provide the functionalities of digital tracking and decision support (DTDS) and include components such as personas, workflows, core data elements, decision-support algorithms, scheduling logic and reporting indicators. Web annexes provide certain components in additional detail including: data dictionary (Web Annex A), decision-support logic (Web Annex B), indicator definitions (Web Annex C), and functional and non-functional requirements (Web Annex D). Data elements within the DAK (Web Annex A) are mapped to standards-based terminology, such as the International Classification of Diseases (ICD), to facilitate interoperability. This DAK focuses on providing the content requirements for a DTDS system for HIV care used by health workers in primary health care settings. It also includes cross- cutting elements focused on the client, such as self-care interventions.