Process of developing the operations manual for delivery of HIV prevention, care and treatment at primary health centres in high-prevalence and resource-constrained settings
This Operations Manual was developed as part of a WHO-PEPFAR collaboration on health centre scale up. Its development involved experienced experts from many implementing partners, WHO and MOH staff active in implementing HIV and related primary health care services as well as other NGOs and FBOs, PLHIV activist groups, bilateral and multilateral agencies.
The process of developing this Operations Manual covers the period of 2007-2008. Each chapter is written by panel writers with a support from iterative expert panels. Electronic review of drafts and several expert meetings were organized to review the recommendations and reach consensus, and to summarize their technical basis and possible country adaptations (these will appear in the IMAI country adaptation guide).
The expert groups assembled all current references and source materials on a share point site. Individual experts contributed their implementation experience and all relevant source material for each chapter. Each chapter was shared with the expert group and all panelists for review. Review comments were assembled in a matrix, discussed when necessary from a technical point of view, then incorporated.
Who was involved and their declaration of interests
The following experts were involved in the development of the Operations Manual. Their contributions are acknowledged. None of the experts declared any conflict of interest.
Organizing Committee of WHO-PEPFAR Scale Up Collaboration: Tedd Ellerbrock, Centers for Disease Control & Prevention (CDC) Global AIDS Program; Robert Ferris, USAID; Sandy Gove and Jos Perriens, WHO.
Contributing writers (with technical input from many panellists)
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Chapter 1-Introduction and guiding principles
Mary Lou Lindegren, Sandy Gove, Miriam Taegtmeyer |
Chapter 2-Planning for integrated HIV services at the health centre
Sandy Gove, KJ Seung, Eyerusalem K, Negussie (paediatrics), Barb Marston (adult) |
Chapter 3-Service integration, linkages and Triage
Steve Lee, KJ Seung, Sandy Gove |
Chapter 4-Community
Ana Bodipo-Memba, Kevin Moody, Kirsty McHarry |
Chapter 5-Infrastructure
Miriam Rabkin, KJ Seung, Sandy Gove, Yves Chartier |
Chapter 6- Monitoring HIV Services, patients and programmes
Tisha Mitsunaga, Renee Fiorentino, Laura Porter, Sisay Sirgu |
Chapter 7-Supply management
Peter Graaff, Kenji Tamura, Heidi Mihm, Paul J, Weidle |
Chapter 8-Laboratory services
Tom Spira, Vincent Habiyambere |
Chapter 9-Human resources
KJ Seung, Estelle Quain, David Lowrance, Alexandra Zuber, Eileen Petit-Mshana |
Chapter 10-Leadership and management
Gundo Weiler, Lou McCallum |
Chapter 11-Quality improvement
Bruce Agins, KJ Seung, Jim Heiby |
Overall editing:
Sandy Gove, Kirsty McHarry, Mary Lou Lindegren, Sandra Woods |
Contributing experts panels for the Operations Manual
Panel CHAIRS are indicated in capitals
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| Adult HIV care and treatment | Human resources and community mobilization expert panel |
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| Anthony Amoroso | AIDS Relief | Ana Bodipo-Memba | USAID |
| Yibeltal Assefa | Ministry of Health, Ethiopia | David Lowrance | CDC |
| Carmen Casonova | WHO NUT | Kevin Moody | GNP+ |
| Bruce Dick | WHO CAH | Ruth Maginoh Olwit | Ministry of Health, Uganda |
| Julia Downing | African Palliative Care Association, Uganda | Eileen PETIT-MSHANA | WHO HIV |
| Wafaa El-Sadr | ICAP, Columbia University | Estelle Quain | USAID |
| Richard Marlink | EGPAF | KJ SEUNG | Harvard Brigham & Women's Hospital |
| Barb MARSTON | CDC GAP | Alexandra Zuber | CDC GAP |
| Kirsty McHarry | WHO HIV | | |
| Johanna Ncala | Treatment Action Campaign | | |
| Lennah Nyabiage | Ministry of Health, Kenya | | |
| Tim Quick | USAID | | |
| David Stanton | USAID | | |
| Patient monitoring | Paediatric HIV care and treatment |
|---|
| Abdikamal Alisalad** | WHO AFRO | Siobhan Crowley | WHO HIV |
| Andrew Boullé | University of Western Cape | Bob Ferris | USAID |
| Kevin Bellis | HLSP | Robert Gass** | UNICEF |
| Batya Elul | ICAP, Columbia University | Sanjiv Lewin | AIDS Relief |
| Renee FIORENTINO | MEASURE Evaluation/JSI | Lulu Muhe | WHO CAH |
| Christian Gunneberg | WHO/STB | Eyerusalem K, NEGUSSIE | WHO HIV |
| Lisa Hirschhorn** | JSI/Harvard | Molly Rivadineira | CDC GAP |
| Tisha MITSUNAGA | MEASURE Evaluation/JSI | Diana Silimperi** | MSH |
| Sara Pacqué-Margolis | EGPAF | Denis Tindyebwa | EGPAF, Tanzania |
| Laura Porter | CDC GAP | Nathan Tumwesigye | ANNECA |
| KJ Seung** | Harvard Brigham & Women's Hospital | | |
| Diana Silimperi ** | MSH | | |
| Kristen Stafford** | AIDS Relief | | |
| Andrea Swatzendruber | CDC GAP | | |
| Paul Bouey | OGAC | | |
| Fatu Forma | CDC GAP | | |
| Reuben Granich | WHO HIV | | |
| **Panellists also on the quality expert panel | | |
| Integration | Laboratory |
|---|
| Carmela Abate | AIDS Relief | Bob Colebunders | Institute of Tropical Medicine, Antwerp |
| Dominique Egger | WHO HSS/HDS | Joyelle Dominique | AIDS Relief |
| Robin Flam | ICAP Columbia University, New York | Sandy Gove | WHO HIV |
| Sandy Gove | WHO HIV | Vincent Habiyambere | WHO HIV |
| Reuben Granich | WHO HIV | Patrick Ikani | FHI, Nigeria |
| Donna Higgins | WHO HIV | John Ridderhof | CDC |
| Steve Lee | EGPAF | Anita Sands | WHO EHT |
| Barb Marston | CDC GAP | Leland Schuller | EGPAF |
| Kirsty MCHARRY | WHO HIV | Tom SPIRA | CDC GAP |
| Kevin Moody | GNP+ | Amilcar Tanuri | ICAP Columbia University |
| KJ Seung | Harvard Brigham & Women's Hospital | Gaby Vercauteren | WHO EHT |
| Miriam Taegtmeyer | CDC GAP | Karin Weyer | WHO STB |
| PMTCT | Prevention |
|---|
| Mathew Chersich | International Centre for Reproductive Health, Kenya | Pam Bachanas | CDC GAP |
| Halima DAO | CDC GAP | Rejoice Nkambule | MOH Swaziland |
| Rene Ekpini | UNICEF | Innocent Ntaganira | WHO AFRO |
| Fatu FORNA | CDC GAP | Kevin O'REILLY | WHO HIV |
| Peggy Henderson | WHO CAH | Vladimir Poznyak | WHO MSD |
| Viviana Mangiaterra | WHO MPS | | |
| Razia Pendse | WHO MPS | | |
| Nathan Shaffer | CDC GAP | | |
| Tin Tin Sint | WHO HIV | | |
| Elizabeth Stringer | CIDRZ, Zambia | | |
| Fatima Tsiouris | ICAP Columbia University | | |
| Cathy Wilfert | EGPAF | | |
| Quality | Supply Chain Management |
|---|
| Bruce AGINS | HIVQUAL | James Batuka | Catholic Relief Services |
| Margaret Palumbo | HIVQUAL | Yasmin Chandani | JSI |
| Clemons Steinbeck | HIVQUAL | Karen Day | MSF |
| Rick Berzon | USAID | Peter GRAAFF | WHO HIV, Afghanistan |
| Robin Flam | ICAP, Columbia | David Hoos | ICAP, Columbia University |
| Yujiro Handa | JICA, Kenya | Mike Hope | USAID |
| La Mar Hasbrouck | CDC GAP | Bianca Kamps | UNICEF |
| Jim Heiby | USAID | Thomas Lapnet-Moustapha | WHO AFRO |
| Dennis Israelski | Pangaea Global AIDS Foundation, SF | Heidi Mihm | USAID |
| Babajide Keshinro | FHI/GHAIN, Nigeria | Atieno Ojoo | UNICEF |
| Wuleta Lemma | Tulane University, Ethiopia | Eva Ombaka | EPN |
| Rashad Masoud | URC-CHS | Rich Owens | Partnership for Supply Chain Management |
| Binod Mahanty | MEASURE Evaluation/JSI | Fernando Pascual | MSF |
| Jose Morales | HRSA | Rose Shija | WHO Tanzania |
| Nilu Rimal | US Department of Defense | Kenji TAMURA | WHO HIV |
| Sue Willard | EGPAF | Helena Walkowiak | Management Sciences for Health |
| Kristen STAFFORD | AIDS Relief | Paul J. Weidle | CDC |
| | Lee Yerkes | EGPAF, Drug Procurement and Logistics |
| **additional panellists on patient monitoring and paediatric expert panel | | |
| Infrastructure | Leadership, Administration and Fiscal Management |
|---|
| Patrick Balcazar | Engineers without Borders, Puerto Rico | Dela Dovlo | WHO HSS/HDS |
| Miriam Rabkin | ICAP Columbia University | Dominique Egger | WHO HSS/HDS |
| KJ Seung | Harvard Brigham & Women's Hospital | Paul Mahanna | USAID |
| Chartier Yves | WHO PHI | Lou McCallum | AIDS Projects Management Group |
| | Deus B Mubangizi | AIDS Relief |
| | Tshi Neluheni | EGPAF, RSA |
| | Gundo Weiler | WHO Ukraine |
| | Isaac Zulu | CDC Zambia |
| TB/HIV | Testing and Counselling |
|---|
| Amy BLOOM | USAID | Naomi Bock | CDC GAP |
| Anand DATE | CDC GAP | Kadidiatou Gouro | WHO AFRO |
| Ritta Dlodlo | IUATLD | Donna HIGGINS | WHO HIV |
| Haileyesus Getahun | WHO STB | Elizabeth MARUM | CDC GAP |
| Amy Ginsburg | EGPAF | Buhle Ncube | WHO AFRO |
| Reuben GRANICH | WHO HIV | Bharat Parek | CDC GAP |
| Bess MILLER | CDC GAP | Gloria Sangiwa | FHI Arlington, VA |
| Alwyn Mwinga | CDC Zambia | Allison Schilsky | CDC GAP |
| Rose Pray | WHO STB | Daphne Spencer | British Columbia Center For Disease Control |
| Papa Salif Sow | Infectious Diseases Fann Hospital, Senegal | Alison Surdo | USAID |
| KJ Seung | Harvard Brigham & Women's Hospital | Miriam Taegtmeyer | Liverpool School of Tropical Medicine |
| | Rhoda Wanyenze | Mulago-Mbarara Teaching Hospitals' Joint AIDS Programme/Makerere University Faculty of Medicine |
| Marco Vitoria | WHO HIV | | |
| Mukadi Ya Diul | FHI Arlington, VA | | |
The HIV/AIDS Department at WHO, plans to review the need to update this Manual in December 2009 after field-testing and closely monitored adaptation and early use by countries and partners.
Graphics: L'IV Com Sàrl, Le Mont-sur-Lausanne, Switzerland
Logo drawings: Claudio Afonso
Credits for specific chapters
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| Chapter 5 | Infrastructure: John Snow, Inc./DELIVER in collaboration with the World Health Organization. Guidelines for the storage of essential medicines and other health commodities. 2003. Arlington, Virginia, USA Dr Rod Escombe, Imperial College London; Blackwood Solar Systems.
USAID.: ohn Snow, Inc./DELIVER, for the USAID.
Cecile Arnaud, consultant, WSH-WHO |
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| Chapter 7 | Supply Management: WHO, Handbook of supply management at fi rst-level health care facilities released - 1st version country adaptation. 2006, Geneva.
John Snow, Inc. /DELIVER in collaboration with the World Health Organization. Guidelines for the storage of essential medicines and other health commodities. 2003. Arlington, Virginia, USA
Va.: John Snow, Inc./DELIVER, for the US Agency for International Development. |
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| Chapter 8 | Laboratory: AFB smear staining poster - a joint effort by WHO, RIT, IUATLD, CDC,
How to do the rapid test for malaria - a joint effort of TDR, WHO, USAID, Quality Assurance Project.
CDC editor Amy S Elkavich CDC illustrators - Alissa Eckert, Don Freggens, Dan Higgins, James Archer
Technical support during consultation and production: Tonia Poteat, CDC and Biya Berhanu, Etsehiwot, WHO
Management support to panels: Louise Perry, CDC |
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