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Monitoring quality and coverage of harm reduction services for
                people who use drugs: a consensus study

# metadata.dc.description.abstract[].value
BACKGROUND AND AIMS: Despite advances in our knowledge of
                effective services for people who use drugs over the last
                decades globally, coverage remains poor in most countries, while
                quality is often unknown. This paper aims to discuss the
                historical development of successful epidemiological indicators
                and to present a framework for extending them with additional
                indicators of coverage and quality of harm reduction services,
                for monitoring and evaluation at international, national or
                subnational levels. The ultimate aim is to improve these
                services in order to reduce health and social problems among
                people who use drugs, such as human immunodeficiency virus (HIV)
                and hepatitis C virus (HCV) infection, crime and legal problems,
                overdose (death) and other morbidity and mortality. METHODS AND
                RESULTS: The framework was developed collaboratively using
                consensus methods involving nominal group meetings, review of
                existing quality standards, repeated email commenting rounds and
                qualitative analysis of opinions/experiences from a broad range
                of professionals/experts, including members of civil society and
                organisations representing people who use drugs. Twelve priority
                candidate indicators are proposed for opioid agonist therapy
                (OAT), needle and syringe programmes (NSP) and generic
                cross-cutting aspects of harm reduction (and potentially other
                drug) services. Under the specific OAT indicators, priority
                indicators included 'coverage', 'waiting list time', 'dosage'
                and 'availability in prisons'. For the specific NSP indicators,
                the priority indicators included 'coverage', 'number of
                needles/syringes distributed/collected', 'provision of other
                drug use paraphernalia' and 'availability in prisons'. Among the
                generic or cross-cutting indicators the priority indicators were
                'infectious diseases counselling and care', 'take away
                naloxone', 'information on safe use/sex' and 'condoms'. We
                discuss conditions for the successful development of the
                suggested indicators and constraints (e.g. funding, ideology).
                We propose conducting a pilot study to test the feasibility and
                applicability of the proposed indicators before their scaling up
                and routine implementation, to evaluate their effectiveness in
                comparing service coverage and quality across countries.
                CONCLUSIONS: The establishment of an improved set of validated
                and internationally agreed upon best practice indicators for
                monitoring harm reduction service will provide a structural
                basis for public health and epidemiological studies and support
                evidence and human rights-based health policies, services and
                interventions.

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Harm Reduction Journal, 2017, vol. 14, num. 1, p. 19

# metadata.dc.source[].value
Articles publicats en revistes (ISGlobal)

# metadata.dc.title[].value
Monitoring quality and coverage of harm reduction services for
                people who use drugs: a consensus study