Implementing the Integration of Component Services for Reproductive Health

Abstract

In the wake of the 1994 International Conference on Population and Development in Cairo, considerable activity has occurred both in national policymaking for reproductive health and in research on the implementation of the Cairo Program of Action. This report considers how effectively a key component of the Cairo agenda--integration of the management of sexually transmitted infections, including human immunodeficiency virus, with maternal and child health-family planning services--has been implemented. Quantitative and qualitative data are used to illuminate the difficulties faced by implementers of reproductive health programs in Ghana, Kenya, South Africa, and Zambia. In these countries, clear evidence is found of a critical need to reexamine the continuing focus on family planning services and the nature of the processes by which managers implement reproductive health policies. Implications of findings for policy and program direction are discussed.

The impact of Prevention of Mother to Child Transmission (PMTCT) programmes on maternal health care in resource‐poor settings: looking beyond the PMTCT programme—a systematic review

“…The degree of verticality of the delivery of PMTCT services differs between countries and between PMTCT sites. 7,11 The level of verticality of a PMTCT programme is influenced by factors such as strong leadership and political commitment at the national level to prohibit earmarked funding. 12 From the findings, it appears that most PMTCT services are delivered in a semi-integrated way.…”

The Impact of Decentralisation on Sexual and Reproductive Health Services in Ghana

“…Structured and semi-structured interviews (using open and closed-ended questions) were conducted with 87 clinical staff and facility managers at 27 facilities purposively sampled by type and location throughout the Upper East Region. The results of structured facility-level interviews and service delivery analysis have been discussed elsewhere 2,3 and are not presented here.…”

Between Intent and Achievement in Sector-Wide Approaches: Staking a Claim for Reproductive Health

“…The risk of specific marginalized target groups -the young, the single, the socially and economically disadvantaged -not being addressed in integration of contraception, STD and HIV/AIDS services into mainstream services has been an issue of concern [38,39]. Access to contraceptives may be significantly enhanced through the promotion of managed competition and the more positive engagement of the private sector, though quality control of services, subsidy of the poor and sharing of client data to ensure overall coverage in immunisation or family planning are difficult to achieve.…”