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Introduction
09-18-2008
- Zambia is one of Sub-Saharan African countries worst affected by HIV/AIDS pandemic.
- AIDS is end stage of infection caused by HIV
- Almost all infections in Zambia due to HIV-1, which progresses rapidly and has high morbidity and mortality
- HIV transmission in Zambia mainly through heterosexual contact, exacerbated by high-risk sexual practices, gender inequality, poverty, stigma discrimination, and high prevalence of sexually transmitted infections (STIs) and TB
- Remaining transmission is predominantly mother-to-child transmission (MTCT) during pregnancy, at birth, or through breast-feeding.
- High prevalence of HIV-related illness has overburdened Zambian health care system at all levels.
- -Counselling: Psychosocial support, including stress/anxiety reduction and promotion of positive living as well as helping individuals make informed decisions on HIV testing, planning for future, behavioral change and involving sexual partners in such decisions.
- -Clinical management: Early diagnosis, rational treatment and planning for follow up care of HIV-related illnesses.
- -Home-based and palliative care: To promote and maintain hygiene and nutrition, provide palliative care, educate individuals and families and practice universal infection control.
- -Social support: Information and referral for participation in community-based PLHA support groups, welfare services and legal advice for individuals and families. Where feasible, technical and material assistance can also be given.
- Care elements should be supported by an efficient referral mechanism for continuum of health care, as early access to the continuum ensures early treatment of TB, earlier recognition of HIV-related illnesses, maternal and child healthcare and better primary health care.
- There is need to care for and manage patients with HIV & AIDS. Focus must be on providing cost-effective and quality health care and support as close to family as possible.
- To achieve goals of national HIV &AIDS response, HIV+ individuals, family/community members and health care workers/volunteers at institutional and community level must have access to HIV & AIDS management and care guidelines.
- Proper management of HIV infection and its complications has been shown to benefit patients by reducing transmission of HIV and opportunistic infections (OIs).
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Purpose:
- -To assist health care personnel in diagnosis, medical management, psychosocial referral and counseling of HIV+ persons and patients presenting with AIDS-defining conditions.
- -To serve as teaching aid for health professionals at different levels
- -To serve as a teaching aid for community-based volunteers and support groups.
- -To assist in projecting resource requirements for HIV and AIDS epidemics by partially specifying resources required for patient care.
- -To inform National M&E Framework through NARF
- Designed to provide practical help in recognizing symptomatic HIV infection and OIs using clinical and laboratory criteria.
- To be adhered to by all HIV governmental and nongovernmental organizations and individuals implementing programmes and projects providing treatment, care and support to PLHA.
- Provide universal access to antiretroviral therapy (ART) including access to Confidential Counselling and Testing (CCT) at all Treatment Centres
- Expand treatment for TB, STIs and other OIs.
- Strengthen home/community-based care and support including access to comprehensive palliative care and pain management
- Support utilization of alternative and/or traditional medicines which have scientifically demonstrated efficacy
- Promote appropriate nutrition and positive living for PLHA
- Multidisciplinary and multi-sectoral approach necessary.
- Information and education as integral part of comprehensive management and care package for persons with HIV and/or presenting with advanced HIV infection.
- A minimum health package of care and support for persons with advanced HIV infection should be made available to both patient and medical personnel attending to them.
- A minimum health package of care and support for persons with advanced HIV infection should be made available to community based health service organizations (CBOs & FBOs )
- Persons with advanced HIV infection should receive full medical care for the OIs and other conditions they may present with.
- All persons with HIV&AIDS should be treated with dignity and care by all healthcare providers and should not be discriminated against as a result of their status.
- Efficient referral, support and care systems for persons with HIV/AIDS should be utilized and made easily accessible in response to care needs of patients.
- These guidelines apply to health care service providers in public and private sectors.
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