Does service integration improve the sexual and reproductive healthcare of women living with HIV?

Wielding, Sally; Flynn, Beverly C.

doi:10.1177/0956462415606341

Cited by 3 publications

(19 citation statements)

References 6 publications

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“…; Phiri et al. ), two in Europe (Coyne, Hawkins, and Desmond ; Wielding and Flynn ) and one in Asia (Thyda et al. ) (Appendix Table ).…”

Section: Resultsmentioning

confidence: 99%

“…In nine of the integration models, women could obtain FP services and commodities without leaving the building where they received HIV care and treatment—what we call a “one‐stop shop” model. The one‐stop shop models varied from services provided in the same room by the same provider—used for example by an integrated HIV care and treatment clinic in Malawi and an integrated genitourinary medicine and sexual and reproductive health care center in Scotland (Wielding and Flynn ; Phiri et al. )—to services provided in different rooms by different providers within the same clinic building (Kosgei et al.…”

Section: Resultsmentioning

confidence: 99%

“…For the sites that began providing long‐acting reversible contraceptive (LARC) methods, training on insertion and removal was more formalized, often involving a certification process (Sarnquist et al. ; Wielding and Flynn ). Several evaluations also explicitly described ongoing training through regular supportive supervision visits (Chabikuli et al.…”

Section: Resultsmentioning

confidence: 99%

“…) or on‐site support by FP specialists (Thyda et al. ; Wielding and Flynn ). Some evaluations acknowledged challenges in adequately training the health providers delivering the intervention because of staff turnover or inadequate planning or budgeting to ensure that all key staff were trained, or low demand for intrauterine devices (IUDs) limiting the chance to gain practical experience in insertion and removal (Sarnquist et al.…”

Section: Resultsmentioning

confidence: 99%

“…Integrated programs were evaluated in 12 countries with varying economic and sociopolitical contexts. Nine studies were conducted in sub-Saharan Africa (Chabikuli et al 2009;Chibwesha et al 2011;Kosgei et al 2011;McCarraher et al 2011;Church et al 2012; Grossman et al 2013;Shade et al 2013;Baumgartner et al 2014;Hoke et al 2014;Sarnquist et al 2014;Church et al 2015;Onono et al 2015;Wanyenze et al 2015;Phiri et al 2016), two in Europe (Coyne, Hawkins, and Desmond 2007;Wielding and Flynn 2015) and one in Asia (Thyda et al 2015) (Appendix Table A1). The integration settings represent the World Bank categories for economic development: low-income (Cambodia, Malawi, Tanzania, Uganda, and Zimbabwe), lower middle-income (Kenya, Nigeria, Swaziland, and Zambia), upper middle-income (South Africa), and high income (England and Scotland).…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

Integration of Family Planning Services into HIV Care and Treatment Services: A Systematic Review

Haberlen¹,

Narasimhan²,

Beres³

et al. 2017

Studies in Family Planning

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Evidence on the feasibility, effectiveness, and cost‐effectiveness of integrating family planning (FP) and HIV services has grown significantly since the 2004 Glion Call to Action. This systematic review adds to the knowledge base by characterizing the range of models used to integrate FP into HIV care and treatment, and synthesizing the evidence on integration outcomes among women living with HIV. Fourteen studies met our inclusion criteria, eight of which were published after the last systematic review on the topic in 2013. Overall, integration was associated with higher modern method contraceptive prevalence and knowledge, although there was insufficient evidence to evaluate its effects on unintended pregnancy or achieving safe and healthy pregnancy. Evidence for change in unmet need for FP was limited, although two of the three evaluations that measured unmet need suggested possible improvements associated with integrated services. However, improving access to FP services through integration was not always sufficient to increase the use of more effective (noncondom) modern methods among women who wanted to prevent pregnancy. Integration efforts, particularly in contexts where contraceptive use is low, must address community‐wide and HIV‐specific barriers to using effective FP methods alongside improving access to information, commodities, and services within routine HIV care.

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“…; Phiri et al. ), two in Europe (Coyne, Hawkins, and Desmond ; Wielding and Flynn ) and one in Asia (Thyda et al. ) (Appendix Table ).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Integration of Family Planning Services into HIV Care and Treatment Services: A Systematic Review

Haberlen¹,

Narasimhan²,

Beres³

et al. 2017

Studies in Family Planning

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Integrating services to improve quality of care for women living with HIV: A global systematic review

et al. 2022

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Objectives:The aim was to review and analyse evidence on the impact of service integration on quality of care for women living with HIV.Methods: Evidence search in September 2020 using the PICO format yielded 60 potential papers. Inclusion required evidence of measurement of an outcome associated with service delivery within a system showing clear integration of services exclusively for women living with HIV. In all, 60 papers were screened, 27 were excluded at the abstract stage, and 17 were excluded after full text review, leaving 20 final papers included in this review.Results: Three papers measured the impact of integrating sexual health services and all showed some measure of improved quality of care. Outcome measures considered in this paper were impact on uptake, prevention, user satisfaction, user knowledge and cost-effectiveness. Ten papers studied the impact of integrating family planning, with eight papers suggesting positive outcomes. Eleven papers studied integrated cervical cytology services with 10 able to demonstrate positive impact. Two papers assessed integrating menopause services and two looked at integration of psychological and social services. The most described positive impact was improved user knowledge and satisfaction. There were two main methods of integration demonstrated, described as 'upskilling' of staff and 'guest services'. Conclusions: Integrating services can create opportunities to improve the quality of patient-centred care whilst promoting the sexual, reproductive and human rights of women living with HIV, with an emphasis on designing services to suit local contexts.

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Health facility-based interventions and the uptake of contraception among people living with HIV: A systematic review & meta-analysis

Revathy,

Chaurasia,

Shetty

et al. 2023

Indian Journal of Medical Research

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Background & objectives: The prong 2 of 4 prong strategy introduced by the World Health Organization aims at averting unintended pregnancies among people living with HIV (PLHIV). This systematic review aimed to generate evidence on the effectuality of facility-based interventions in improving uptake of modern and dual contraception, for reducing unmet family planning (FP) needs and unintended pregnancies among PLHIV. Methods: Articles evaluating facility-based interventions to integrate human immunodeficiency virus (HIV) and FP published in English language were included. Eligible studies were identified from electronic and lateral search from three databases (PubMed, Cochrane Library and Web of Science) and grey literature. HIV care with no/minimal focus on FP was considered a comparator. Quality was assessed using design-appropriate tools. Descriptive analysis was presented in tables. Uptake of dual methods, unmet FP needs and unintended pregnancies were included in the meta-analysis to estimate pooled odds ratio (OR) with random effect model, P and I 2 values. Results: The search yielded 2112 results. After excluding duplicates and unfit articles, 17 were found eligible for review and nine for meta-analysis. The pooled OR for uptake of dual contraception was 1.69 (1.14, 2.5) (P=0.008; I 2=90%), for unmet FP needs was 0.58 (0487, 0.69) (P<0.00001; I 2=0%) and for unintended pregnancies was 0.6 (0.32, 1.1) (P=0.1, I 2=38%). Interpretation & conclusions: The results of this meta-analysis suggest that health facility-based interventions to integrate HIV and FP services do result in improved uptake of dual methods and reduce unmet need for contraception along with a protective trend on incidence of unintended pregnancies. Such facility-based integration would ensure universal access to effective contraception and facilitate in achieving Sustainable Development Goals that aim at ending epidemics like HIV.

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Does service integration improve the sexual and reproductive healthcare of women living with HIV?

Cited by 3 publications

References 6 publications

Integration of Family Planning Services into HIV Care and Treatment Services: A Systematic Review

Integration of Family Planning Services into HIV Care and Treatment Services: A Systematic Review

Integrating services to improve quality of care for women living with HIV: A global systematic review

Health facility-based interventions and the uptake of contraception among people living with HIV: A systematic review & meta-analysis

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