Feasibility, acceptability, effectiveness and cost of models of integrating HIV prevention and counseling and testing for HIV within family planning services in North West Province, South Africa

Mullick, Saiqa; Menziwa, Mantshi; Mosery, Nzwakie; Khoza,; Maroga, Edwin

doi:10.31899/rh4.1214

Cited by 8 publications

(8 citation statements)

References 2 publications

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“…A study in South Africa, examining the feasibility and acceptability of integrating counseling and testing services in family planning clinics, found that family planning clients were at risk of contracting HIV and other sexually transmitted infections (STIs). Although 17 % had multiple partners, 30 % knew their HIV status, and 40 % did not use a condom at last sex, while only 23 % of clients perceived a high risk of HIV [ 16 ]. This study further investigated the predictors of utilization of HIV and SRH services, the latter encompassing family planning services, prenatal, delivery care and post-delivery.…”

Section: Introductionmentioning

confidence: 99%

Utilization of integrated HIV and sexual and reproductive health services among women in Uganda

Rutaremwa

Kabagenyi

2016

BMC Health Serv Res

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BackgroundWhile the rationale for integration of HIV and sexual and reproductive health (HIV and SRH) services is strong, there is paucity of information on which population groups most utilize these services. Such studies would inform policy and programs on integration of services. The overall objective of this assessment is to provide information to researchers, planners and policy makers on the best practices for integrated services in order to maximize feasibility of scaling up. Specifically, this research paper identifies demographic and socioeconomic factors that are most related to utilization of integrated services in Uganda.MethodsThis manuscript uses data from a sample of 9,691 women interviewed during the Uganda AIDS Indicator Survey (UAIS) of 2011. The selection criteria of the study respondents for this paper included women of reproductive age 15 – 49 years. The dependent variable is whether the respondent utilized integrated HIV and SRH services during pregnancy and delivery of the last child, while independent variables include; region of residence, age-group of woman, marital status, rural-urban residence, wealth indicator and educational level attainment. In the main analysis, a binary logistic regression model was fitted to the data.ResultsLog-odds of utilizing integrated services were significantly higher among those women with a primary education (OR = 1.2, 95 % CI = 1.0-1.4, p < 0.05) compared to those with no education. Women from the Central part of Uganda were more likely to utilize integrated HIV and SRH services (OR = 1.3, 95 % CI = 1.0-1.7, p < 0.05), further the log-odds of utilizing integrated HIV and SRH services were significantly higher among women residing in Northern region (OR = 1.6, 95 % CI = 1.2-2.2, p < 0.01). The odds of utilization of integrated HIV and SRH services were higher for currently married women (OR = 6.6, 95 % CI = 5.5-8.0, p < 0.01) and the formerly married (OR = 3.4, 95 % CI = 2.7-4.2, p < 0.01), compared to the never married group. The odds of utilizing integrated HIV and SRH services were higher for younger women of ages less than 35 years compared to older women aged 40 – 49 years.ConclusionsUtilization of integrated HIV and SRH services in Uganda is influenced greatly by demographic and socioeconomic characteristics. This study contributes to the current debate as it shows the on how best ways to improve HIV and SRH service delivery to the people.

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Section: Introductionmentioning

confidence: 99%

Utilization of integrated HIV and sexual and reproductive health services among women in Uganda

Rutaremwa

Kabagenyi

2016

BMC Health Serv Res

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“…Eleven studies and/or evaluations (see Table 3) provided evidence that promoting contraceptives and family planning as a routine part of HIV services (and vice versa) may increase condom use, contraceptive use and dual method use [17][18][19][20][21][22][23][24][25][26][27]. Providing these integrated services can avert unintended pregnancies among women living with HIV.…”

Section: Interventions That Work Promoting Contraceptives and Family mentioning

confidence: 99%

What works to meet the sexual and reproductive health needs of women living with HIV/AIDS

Hardee

Croce-Galis

Hall

2011

Journal of the International AIDS Society

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It is critical to include a sexual and reproductive health lens in HIV programming as most HIV transmission occurs through sexual intercourse. As global attention is focusing on the sexual and reproductive health needs of women living with HIV, identifying which interventions work becomes vitally important. What evidence exists to support sexual and reproductive health programming related to HIV programmes?This article reviews the evidence of what works to meet the sexual and reproductive health needs of women living with HIV in developing countries and includes 35 studies and evaluations of eight general interventions using various methods of implementation science from 15 countries. Data are primarily from 2000-2009. Searches to identify effective evaluations used SCOPUS, Popline, Medline, websites and consultations with experts. Evidence was ranked using the Gray Scale.A range of successful and promising interventions to improve the sexual and reproductive health and rights of women living with HIV include: providing contraceptives and family planning counselling as part of HIV services; ensuring early postpartum visits providing family planning and HIV information and services; providing youth-friendly services; supporting information and skills building; supporting disclosure; providing cervical cancer screening; and promoting condom use for dual protection against pregnancy and HIV. Provision of antiretrovirals can also increase protective behaviours, including condom use.While many gaps in programming and research remain, much can be done now to operationalize evidence-based effective interventions to meet the sexual and reproductive health needs of women living with HIV.

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“…The investigation focused on technical quality of care ( Donabedian 1988 ; Blumenthal 1996 ; Evans et al 2001 ; Øvretveit 2002 ), rather than on quality of care more broadly. Arguments for integration of HIV and reproductive health services in the literature point to increases in service uptake mainly due to: availability of an expanded and accessible range of services to the client per clinic visit, and improved clinical interaction between the client and provider ( Foreit et al 2002 ; Kaba and Alem 2006 ; Mullick et al 2006 ; Liambila et al 2008 ; Church and Mayhew 2009 ; Spaulding et al 2009 ; Pfeiffer et al 2010 ). Both these factors relate to technical quality of care ( Donabedian 1988 ; Evans et al 2001 ).…”

Section: Introductionmentioning

confidence: 99%

Does service integration improve technical quality of care in low-resource settings? An evaluation of a model integrating HIV care into family planning services in Kenya

Mutemwa

Mayhew

Warren

et al. 2017

Health Policy and Planning

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The aim of this study was to investigate association between HIV and family planning integration and technical quality of care. The study focused on technical quality of client–provider consultation sessions. The cross-sectional study observed 366 client–provider consultation sessions and interviewed 37 health care providers in 12 public health facilities in Kenya. Multilevel random intercept and linear regression models were fitted to the matched data to investigate relationships between service integration and technical quality of care as well as associations between facility-level structural and provider factors and technical quality of care. A sensitivity analysis was performed to test for hidden bias. After adjusting for facility-level structural factors, HIV/family planning integration was found to have significant positive effect on technical quality of the consultation session, with average treatment effect 0.44 (95% CI: 0.63–0.82). Three of the 12 structural factors were significantly positively associated with technical quality of consultation session including: availability of family planning commodities (9.64; 95% CI: 5.07–14.21), adequate infrastructure (5.29; 95% CI: 2.89–7.69) and reagents (1.48; 95% CI: 1.02–1.93). Three of the nine provider factors were significantly positively associated with technical quality of consultation session: appropriate provider clinical knowledge (3.14; 95% CI: 1.92–4.36), job satisfaction (2.02; 95% CI: 1.21–2.83) and supervision (1.01; 95% CI: 0.35–1.68), while workload (−0.88; 95% CI: −1.75 to − 0.01) was negatively associated. Technical quality of the client–provider consultation session was also determined by duration of the consultation and type of clinic visit and appeared to depend on whether the clinic visit occurred early or later in the week. Integration of HIV care into family planning services can improve the technical quality of client–provider consultation sessions as measured by both health facility structural and provider factors.

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Feasibility, acceptability, effectiveness and cost of models of integrating HIV prevention and counseling and testing for HIV within family planning services in North West Province, South Africa

Cited by 8 publications

References 2 publications

Utilization of integrated HIV and sexual and reproductive health services among women in Uganda

Utilization of integrated HIV and sexual and reproductive health services among women in Uganda

What works to meet the sexual and reproductive health needs of women living with HIV/AIDS

Does service integration improve technical quality of care in low-resource settings? An evaluation of a model integrating HIV care into family planning services in Kenya

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