RESUMO
BACKGROUND: The Ministry of Health (hereafter, Ministry) of Trinidad and Tobago is responsible for delivery of all health services in the country. The Ministry takes responsibility for direct delivery of care in the public sector and has initiated a process whereby those seeking HIV test results could obtain confidential reports during a single-visit to a testing location. The Ministry requested technical assistance with this process from the Caribbean Epidemiology Centre (CAREC). The United States Centers for Disease Control and Prevention (CDC) played an important role in this process through its partnership with CAREC. METHODS: Under the technical guidance of CAREC and CDC, the Ministry organized a technical working group which included representatives from key national HIV program services and technical assistance partners. This working group reviewed internationally-recognized best practices for HIV rapid testing and proposed a program that could be integrated into the national HIV programs of Trinidad and Tobago. The working group wrote a consensus protocol, defined certification criteria, prepared training materials and oversaw implementation of "same-visit" HIV testing at two pilot sites. RESULTS: A Ministry-of-Health-supported program of "same-visit" HIV testing has been established in Trinidad and Tobago. This program provides confidential testing that is independent of laboratory confirmation. The program allows clients who want to know their HIV status to obtain this information during a single-visit to a testing location. Testers who are certified to provide testing on behalf of the Ministry are also counselors. Non-laboratory personnel have been trained to provide HIV testing in non-laboratory locations. The program includes procedures to assure uniform quality of testing across multiple testing sites. Several procedural and training documents were developed during implementation of this program. This report contains links to those documents. CONCLUSIONS: The Ministry of Health has implemented a program of "same-visit" HIV testing in Trinidad and Tobago. This program provides clients confidential HIV test reports during a single visit to a testing location. The program is staffed by non-laboratory personnel who are trained to provide both testing and counseling in decentralized (non-laboratory) settings. This approach may serve as a model for other small countries.
Assuntos
Sorodiagnóstico da AIDS , Infecções por HIV/diagnóstico , Implementação de Plano de Saúde/métodos , Visita a Consultório Médico , Desenvolvimento de Programas , Centers for Disease Control and Prevention, U.S. , Certificação , Protocolos Clínicos/normas , Feminino , Pessoal de Saúde/educação , Política de Saúde , Humanos , Masculino , Materiais de Ensino , Trinidad e Tobago , Estados UnidosRESUMO
BACKGROUND: The Ministry of Health (hereafter, Ministry) of Trinidad and Tobago is responsible for delivery of all health services in the country. The Ministry takes responsibility for direct delivery of care in the public sector and has initiated a process whereby those seeking HIV test results could obtain confidential reports during a single-visit to a testing location. The Ministry requested technical assistance with this process from the Caribbean Epidemiology Centre (CAREC). The United States Centers for Disease Control and Prevention (CDC) played an important role in this process through its partnership with CAREC. METHODS: Under the technical guidance of CAREC and CDC, the Ministry organized a technical working group which included representatives from key national HIV program services and technical assistance partners. This working group reviewed internationally-recognized best practices for HIV rapid testing and proposed a program that could be integrated into the national HIV programs of Trinidad and Tobago. The working group wrote a consensus protocol, defined certification criteria, prepared training materials and oversaw implementation of "same-visit" HIV testing at two pilot sites. RESULTS: A Ministry-of-Health-supported program of "same-visit" HIV testing has been established in Trinidad and Tobago. This program provides confidential testing that is independent of laboratory confirmation. The program allows clients who want to know their HIV status to obtain this information during a single-visit to a testing location. Testers who are certified to provide testing on behalf of the Ministry are also counselors. Non-laboratory personnel have been trained to provide HIV testing in non-laboratory locations. The program includes procedures to assure uniform quality of testing across multiple testing sites. Several procedural and training documents were developed during implementation of this program. This report contains links to those documents. CONCLUSIONS: The Ministry of Health has implemented a program of "same-visit" HIV testing in Trinidad and Tobago. This program provides clients confidential HIV test reports during a single visit to a testing location. The program is staffed by non-laboratory personnel who are trained to provide both testing and counseling in decentralized (non-laboratory) settings. This approach may serve as a model for other small countries.
Assuntos
Humanos , Masculino , Feminino , Sorodiagnóstico da AIDS , Certificação , Protocolos Clínicos/normas , Infecções por HIV/diagnóstico , Pessoal de Saúde/educação , Implementação de Plano de Saúde/métodos , Política de Saúde , Visita a Consultório Médico , Desenvolvimento de Programas , Materiais de Ensino , Trinidad e Tobago , Estados UnidosRESUMO
The concept of health promotion is not new, but it is the latest approach being promulgated to achieve the elusive entity we call health. What is health and how do we arrange to become healthy? Health is more often thought of and spoken of, in terms of its absence. We describe our health in terms of not being ill. When we feel healthy we do not need to pay much attention to it; we can get on with our lives. Illness on the other hand grabs our attention. The concept of health as the inside-out of illness is reflected in how countries and individuals arrange to be healthy. Many countries put their emphasis on having a clinic or hospital on every corner. Adequate, accessible and effective health/medical care services are of course essential, but it is unfortunate that the little we invest in health is largely devoted to getting better after an illness or injury. This is our conceptual framework, our 'box', on health. The concept of health promotion takes us outside this box. Health becomes an entity in itself, and not merely the absence of illness or disease. The need to get outside the box is pivotal to public health, and to achieving maximum health status for, and by, communities. Health promotion sees health as the result of living conditions and the opportunities or barriers these present for being healthy. Health is promoted by initiatives that ensure people live a life that makes health not only possible, but probable(AU)
Assuntos
Humanos , Promoção da Saúde/métodos , Promoção da Saúde/organização & administração , Promoção da Saúde/tendências , Atenção à Saúde , Política de Saúde/legislação & jurisprudência , Região do CaribeRESUMO
This study sought to assess and describe the state of readiness of, the members of the General Practitioners Association in Kingston and St. Andrew Jamaica, to deal with the HIV epidemic. The nature of the HIV epidemic, its history, its impact on society and number of cases globally, regionally and locally are all described as a background to the problem. The nature and development of the doctor's role in society, his relationship with his patient, and his role in a health crisis such as an epidemic are also discussed. The membership list of the General Practitioners Association was used as sample frame for the study. In choosing the sample the starting point was randomly selected, and selection of sample was completed through the systematic sampling method. This study was pursued because although HIV is more than a medical problem and involves many social and economic issuses, it presents itself as an illness, and those who must needs attend to illnesses will/do have an important role to play in the control of the epidemic. Private general practitioners were examined because the concept of privatization of health care is now current and being mooted. The private sector is also important because it already sees a significant number of persons seeking care. A study looking at the private doctor's role, then could feasibly start with the members of the General Practitioners Assocaiation. More than half the sample felt they were not, or were not sure if the are, ready for the epidemic. This bore out in the data collected. Only 32 percent had treated persons with HIV+AIDS, and only half the sample had diagnosed HIV and/or AIDS. There appears to be willingness however to be involved in the process of educating patients and a sense that controlling the epidemic falls within their area of responsibility. (AU)