Reproductive System & Sexual Disorders: Current Research
Open Access

Case Studies Of AIDS

The case studies of AIDS are mother to child transmission, emergencies and disasters, migrants and mobile workers, youth, HIV discrimination project in Cambodia and Mongolia, Uniformed services, Psychological support, Catchy condoms in Norway, Volunteer contributions.in mother to child transmission the French Red Cross is helping to avoid mother to unborn child transmissions.in emergencies case studies United Nations Population Fund (UNFPA) work to protect reproductive health in complex emergencies.in migrants and mobile workers studies it works on diverse health projects eastern shah state. Youth case studies focus on prevention through peer education. In HIV discrimination project in Cambodia and Mongolia case study deals with it supports with people affected by HIV.HIV and AIDS Review,HIV clinician / Delta Region AIDS Education & Training Center,Hopkins HIV report : a bimonthly newsletter for healthcare providers / Johns Hopkins University AIDS Service,Canadian HIV/AIDS policy & law review / Canadian HIV/AIDS Legal Network,Journal of HIV/AIDS and Social Services.National strategic information related to the scale-up of programmes on HIV/AIDS and other integrated programmes has taken an increasingly important role as countries strengthen their health systems. To support the effective use of strategic information on health, an international group of organizations has joined forces; collaborators include the World Health Organization (WHO), the Joint United Nations Programme on HIV/AIDS (UNAIDS), the Centers for Disease Control and Prevention (CDC), and the Global Fund to Fight AIDS, Tuberculosis, and Malaria (GFATM). In this case study, we document Botswana’s experience in country-enhanced monitoring and evaluation of antiretroviral therapy scale-up, and show the feasibility of applying well-known triangulation methods to integrate multiple data sets from national monitoring mechanisms. Together with capacity building, innovative approaches help to create stronger health information systems, and we hope that this case study will contribute to the adoption of bold new methods. We will summarize triangulation, and other analysis methodologies that have been effectively applied at the national and subnational levels, in a forthcoming resource manual (to be published in 2007). The international partners and Botswana’s National AIDS Coordinating Agency (NACA) wish to thank all the people who have provided valuable inputs and suggestions for this publication. In particular, we are grateful to the staff, clients and programme managers at different levels in Botswana who volunteered their experience. We are also grateful to the public health professionals who worked so hard to generate and compile these data. We particularly wish to thank Boga Fidzani at NACA for providing leadership for this project in Botswana, and Rand Stoneburner and the University of California, San Francisco team for conceptualizing and writing this guide.In 2002, the Government of Botswana rolled out a national programme for the treatment of AIDS with antiretroviral therapy (ART). In 2005, the impact of this ART scale-up programme was assessed by the National AIDS Committee of the Botswana Ministry of Health (MOH), together with the World Health Organization (WHO), the Joint United Nations Programme on HIV/AIDS (UNAIDS), and the University of California, San Francisco’s (UCSF) Institute for Global Health, using country-enhanced monitoring and evaluation methodology tailored specifically to the situation in Botswana. Using data from multiple existing sources in a process called “triangulation,” the researchers were able to develop a model to determine the impact of ART in Botswana. Preliminary results indicate that during the 3 years since its inception, the ART programme in Botswana has achieved reductions in mortality of adults aged 25–54 years. Reduced mortality is associated with early initiation of district ART programmes and with the overall rate of ART uptake in the district.a Widespread application of ART has been shown to decrease mortality among individuals and constrained samples of the population. These previously stated findings are the basis for current clinical guidelines (1). This study demonstrates that in Botswana, where excess mortality attributable to AIDS has been estimated to be 83% of all deaths (2), ART has the potential to cause a population-level change in mortality rates. The benefits of a triangulation methodology as applied in Botswana are twofold. First, the use of pre-existing data sources allows the study to be relatively rapidly executed and concluded. This is of particular importance for studies with significant policy or programmatic impact. Second, the systematic collection and examination of data from multiple sources reveals new questions to be studied, permits verification, and reduces the likelihood of data and researcher bias. The limitations imposed by the quality of the existing data remain, but are mitigated by this methodology. The Botswana experience has also identified some of the prerequisites for the effective application of triangulation. It is necessary to be flexible during the analysis, and to consider complementing triangulation studies with additional qualitative and quantitative research, where existing data are not sufficient to answer some questions. Based upon the application of triangulation in Botswana, the engagement of high-level policy-makers and administrators throughout the early part of the triangulation process is critical to the success of data identification and collation, and remains important through the analysis phase.b A week-long training course for representatives from a range of institutions was initiated to build capacity in Botswana for future application of triangulation methods