Introduction
HIV planning requires granular estimates for the number of people living with HIV (PLHIV), antiretroviral treatment (ART) coverage and unmet need, and new HIV infections by district, or ...equivalent subnational administrative level. We developed a Bayesian small‐area estimation model, called Naomi, to estimate these quantities stratified by subnational administrative units, sex, and five‐year age groups.
Methods
Small‐area regressions for HIV prevalence, ART coverage and HIV incidence were jointly calibrated using subnational household survey data on all three indicators, routine antenatal service delivery data on HIV prevalence and ART coverage among pregnant women, and service delivery data on the number of PLHIV receiving ART. Incidence was modelled by district‐level HIV prevalence and ART coverage. Model outputs of counts and rates for each indicator were aggregated to multiple geographic and demographic stratifications of interest. The model was estimated in an empirical Bayes framework, furnishing probabilistic uncertainty ranges for all output indicators. Example results were presented using data from Malawi during 2016–2018.
Results
Adult HIV prevalence in September 2018 ranged from 3.2% to 17.1% across Malawi's districts and was higher in southern districts and in metropolitan areas. ART coverage was more homogenous, ranging from 75% to 82%. The largest number of PLHIV was among ages 35 to 39 for both women and men, while the most untreated PLHIV were among ages 25 to 29 for women and 30 to 34 for men. Relative uncertainty was larger for the untreated PLHIV than the number on ART or total PLHIV. Among clients receiving ART at facilities in Lilongwe city, an estimated 71% (95% CI, 61% to 79%) resided in Lilongwe city, 20% (14% to 27%) in Lilongwe district outside the metropolis, and 9% (6% to 12%) in neighbouring Dowa district. Thirty‐eight percent (26% to 50%) of Lilongwe rural residents and 39% (27% to 50%) of Dowa residents received treatment at facilities in Lilongwe city.
Conclusions
The Naomi model synthesizes multiple subnational data sources to furnish estimates of key indicators for HIV programme planning, resource allocation, and target setting. Further model development to meet evolving HIV policy priorities and programme need should be accompanied by continued strengthening and understanding of routine health system data.
Use words such as 'we', 'you', 'us', 'our' and 'your' to connect with your learners. And don't be afraid to be bold and tell them what they should be doing next.
Spend time thinking about your values and all the facets of your personality that make you who you are. And don't forget to note down examples of the value that you create for your organisation. ...Next, decide which points are most relevant to your work. Organise these into the headings 'values', personality traits', 'skills' and 'results'. Finally, combine all of this into a powerful statement of purpose.
Words of wisdom Ashton, Rob
The Safety & Health Practitioner,
12/2009, Letnik:
27, Številka:
12
Trade Publication Article
But in terms of workplace welfare, giving incorrect directions can be far more costly than a few minutes of discomfort. The financial and legal consequences of any accidents can be substantial, so ...creating clear, accurate written work when communicating health and safety information is essential. Hefty fines and compensation payouts to injured employees won't just hit your company's bottom line; they can also cause a huge loss of reputation and morale. The secret to writing good instructions or procedures is to do lots of ground work. The end result may be a simple point-by-point document, but the real work is done by careful planning. Whether you're writing a poster, sign, leaflet, or training document, use the tips below to make your writing as attention-grabbing and powerful as possible.
If you're just expanding on an already open dialogue, by all means send emails. But think carefully about what you put in the email subject box. Take inspiration from newspaper and magazine headlines ...and choose your words carefully. For instance, 'now is no time for silence' is much more effective than 'this month's communication update'. You can monitor who opens the emails, but it's more difficult to measure how engaged people are with the contents.
The 'write' skills Ashton, Rob
Training Journal,
01/2007
Trade Publication Article
It's a truth universally acknowledged that people's grammar and spelling ain't what it used to be. We've grown accustomed to the cries of despair about today's 'illiterate youth' and the nostalgic ...laments for a return to teaching 'good old-fashioned literacy' in our schools.
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