Many children who become available for intercountry adoption have special needs or identified medical conditions. Those needs and medical conditions can be challenging for a family that is not prepared. We urge you to carefully consider a child’s medical condition and special needs before accepting a referral. Children eligible for adoption often have health conditions that are common in developing countries, but that can be prevented in the United States. Some children have more serious conditions, such as tuberculosis and HIV. In addition, children’s health is often negatively affected by living in an institution.

The type and quality of available medical information about a child can vary greatly between countries. Your adoption service provider should provide you with as much information as possible about the health of a particular child, but it will not be able to guarantee that the information is complete or up-to-date. Typically, the information about a child eligible for adoption will be more comprehensive from Convention countries than from non-Convention countries.

INTRODUCTION

Many lower- and middle-income countries are in the process of scaling up health services as part of strengthening their health
sector and as part of a broader development agenda. Although in many countries such developments are often influenced by
communicable diseases, including human immunodeficiency virus (HIV), tuberculosis (TB) or malaria, the need to improve services
for non-communicable diseases is increasingly recognized. As the range and depth of services provided increases, increasing numbers of people will need to be served, especially in areas previously
neglected by the local health system. The scale-up of health services should be accompanied by an increase in the collection of health information. First, this ensures that all information relevant to the services provided is collected for each individual using those services so that longitudinal personal health information can be available over time as part of the development of a longitudinal health record for that individual. Second, individual-level health information is increasingly used to monitor and evaluate the effectiveness, efficiency, equity and acceptability of service provision at the facility, regional and national level. Use of individual-level information for the second purpose requires the protection of personally identifiable health information by anonymizing or pseudo-anonymizing the information . The use of individual-level information must be balanced carefully with the risks associated with breaching confidentiality. To enhance the effectiveness and efficiency of health systems, the different sectors of these systems need to be linked at policy levels and integrated at the level of service provision. For example, a woman living with HIV who develops carcinoma of the cervix may need to access relevant cancer services and continue to be followed by her HIV clinic for ongoing
HIV management; for this process to be optimum, any element of health data generated in either clinic by the woman needs to be linked to her. This can be facilitated by the existence of a unique health identifier, which will not only simplify the development of a comprehensive longitudinal medical history concerning her management in the HIV clinic, but also ensure that the relevant information from the HIV clinic is available to the clinicians managing her cervical cancer. Furthermore, a unique health
identifier will facilitate tracking across other health sectors within the woman’s country where she uses services. All this needs to be
done within the context of maintaining maximum confidentiality of personally identifiable health information. This document focuses on the development of unique health identifiers at the country
level, referred to as national health identifiers (NHIDs). The purpose of the NHID assigned to an individual is to ensure that the
individual can be repeatedly and correctly identified, thus facilitating capture and storage of all information relating to the
person’s interactions with the health system. Use of NHIDs also ensures availability of this information for monitoring and evaluating health system performance at the facility, regional and national level. This guidance is written principally to support the process of developing NHIDs within middle- and lower-income countries. Although the rationale to establish NHIDs in the context of strengthening health services is clear, the process to develop a solution is more complex and time-consuming. Several countries have made significant progress towards developing NHIDs, but many countries have not arrived at a suitable solution. The process of developing and adopting a NHID is not without challenges. It needs to involve leadership, relevant technological infrastructure and resources. Universal solutions are being developed but are unlikely to exactly match local conditions. The NHID represents the most direct path, but the ultimate objective is to achieve accurate identification of people using health services within the context of the country. Countries that have developed a real-world solution for NHIDs have typically used a mixture of methods. Real-world solutions involve trade-offs or compromises to accommodate economic, cultural or other country-specific conditions. Knowledge of the key principles of developing a NHID and the associated health system infrastructure required to support it will help determine
how to achieve accurate identification of patients on a national scale.

#Health consideration

#tuberculosis and HIV

#INTRODUCTION

#NHID(national health identifiers)