U N I V E R S I T Y O F K I S U M U GREAT LAKES 98 GREAT LAKES UNIVERSITY OF KISUMU (GLUK) COMMUNITY HEALTH ASPECTS OF HIV/AIDS Dan Kaseje, MBChB, MPH, PhD Dan Kaseje, MBChB, MPH, PhD Professor of Public Health, Professor of Public Health, December, 2009 December, 2009
26
Embed
02 Kaseje Hiv Aids And Community Health Dec 3, 09 Sahara
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
UN
IV E R S I T Y O F K I S U MU
GREAT LAKES
98GREAT LAKES UNIVERSITY OF KISUMU (GLUK)
COMMUNITY HEALTH ASPECTS
OF HIV/AIDS
Dan Kaseje, MBChB, MPH, PhDDan Kaseje, MBChB, MPH, PhD
Professor of Public Health,Professor of Public Health,
December, 2009December, 2009
UN
IV E R S I T Y O F K I S U MU
GREAT LAKES
98GREAT LAKES UNIVERSITY OF KISUMU (GLUK)
CONTEXT� 9yrs ago, world leaders set goals to free humanity from the
shackles of extreme poverty, hunger, illiteracy &disease by 2015
� They established quantitative benchmarks for poverty,
malaria and HIV, environmental sustainability and global
partnership for development.
� But progress has been slow, casting doubts as to the
possibility of achieving the goals in Sub-Sahara Africa.
� Less than 6 yrs away, progress is threatened by
unprecedented economic crisis that has led to diminished
resources, fewer opportunities for lower income countries,
worsening already unacceptable DISPARITY (between and within
countries).
Proportion of people living on less than $1.25 a day, 1990, 1999 and 2005 (Percentage)
The global economic crisis derails fight against poverty
� Worldwide, the number of people living in extreme poverty in 2009 is 90 million higher than anticipated before the Global economic crisis
� Minimal poverty reduction in SS Africa, farthest from target
� Steady global reduction
International food price index and consumer food price index in selected countries, 2008 (Year 2000=100)
A decrease in international food prices fails to translate into more
affordable food at local markets� A decrease in international
food prices in the second
half of 2008 was expected to
lower prices in local mkts
� This has not materialized,
and consumer access to
food in many developing
countries, such as Brazil,
India and Nigeria did not
improve as expected
� FOOD PRICE INDEX
HIGHEST IN SS AFRICA.
UN
IV E R S I T Y O F K I S U MU
GREAT LAKES
98GREAT LAKES UNIVERSITY OF KISUMU (GLUK)
SUPPLY SIDE�There is poor preparedness for emerging scenario, inadequate
skills mix (particularly leadership and management) to face
the context
�Competing systems of care contribute to delays in care seeking
(since available, accessible, acceptable) yet ignored and
unregulated (effectiveness unknown). Delayed care seeking leads
to COSTLY CONSEQUENCES�Solutions which tend to be developed outside the context of the problem (by professionals), too simplistic against complex situations surrounding the households, entrapped in the a vicious cycle of poverty and ill-health, as well as layers of disabling socio-economic realities (culture, stigma, discrimination)
UN
IV E R S I T Y O F K I S U MU
GREAT LAKES
98GREAT LAKES UNIVERSITY OF KISUMU (GLUK)
SUPPLY SIDE�CONDOM (less than 50% coverage)
�MALE CIRCUMSCISION (20%)
�VCT, PMTCT (only 10% know their status)
�TREATMENT OF STI (less than 20% access treatment)
�Home based testing
�ART, HAART
�OVC interventions
�Home based care
(all effective yet not reaching hh, individuals enough to change