Case study on sexual and reproductive health and education: reflections on interlinkage and governance

Health systems and the SDGs: lessons from a joint HIV and sexual and reproductive health and rights response

“…Research on linkages (as distinct from service integration) between SRHR and HIV policies suggests that better health outcomes can be achieved when health services, systems and the enabling environment (including supportive policies) take into account social issues and include respect for clients health and human rights; are able to connect multiple service-components through effective linkages between health professionals within the system and who are motivated and enabled to make connections beyond their usual responsibilities, to decrease barriers to access ( UNAIDS 2010 ; Mayhew et al 2016 ; UNFPA, WHO & IPPF 2017 ). Research on country experiences of linking SRH and HIV programmes has also shown that both strong political will and governance are necessary ( Lusti-Narasimhan et al 2014 ; Mayhew et al 2015 ; Waage et al 2015 ; Hopkins and Collins 2017 in this supplement).…”

“…At its simplest it is “ …combining different kinds of services to maximize outcomes ” ( UNAIDS 2011 ). Integration can be bi-directional , with SRH services integrated into HIV services and vice versa; and can be ‘ subdivided’ at facility level in terms of four dimensions: structural integration (services availability, resources, location); functional integration (the range of services each client receives per visit); temporal integration (range of services accessed daily/days per week) and provider integration (services provided per staff per day) ( Mayhew et al 2015 ).…”

“…A health systems perspective is required to build and exploit the synergies both within and across delivery of services and to connect with other sectors. A multi-sectoral perspective, for example the health sector working with ministries of Education, Gender, Social Services and Youth and Sports, achieves a more holistic response to sexual and reproductive health (Danida 2014; Mayhew et al 2015 ). This broader approach has been termed ‘ linkages ’ and refers to the synergies in the enabling environment (laws, policies, funding), health systems (planning and coordination, capacity-building, commodities, monitoring and evaluation), and includes integrated service delivery of SRH and HIV ( IPPF et al 2009 , WHO 2015b ).…”