The Nuts and Bolts of FP/HIV Integration:
Promising Practices and Technical
Considerations
Christian Connections for Inter...
Overview of Presentation
• USG Rationale and Guiding Principles for FP/HIV
• FP/HIV integration approaches and models
• Pr...
Why Support FP/HIV Integration?
FP/HIV Integration assists the US Government to:
• Meet clients’ rights and needs for comp...
1. HIV-positive individuals should be provided with information on, and be able to
exercise voluntary choices about their ...
USG Interagency Activities
• Established the USG Interagency FP/HIV
Task Force
• 2013-2014 PEPFAR FP/HIV Acceleration
Init...
FP/HIV integration approaches and models
• FP/HIV integration service delivery platforms include
• HIV
• Family Planning
•...
Health Systems
Strengthening
Health Systems
Strengthening
Community
engagement
Community
engagement
PMTCT
Option B+
FP MCH...
Programming for Specific Populations
• Women of reproductive age
• PLHIV
• Other women at risk of HIV
• Key populations
• ...
USAID/Uganda
(Below) Marie Stopes Uganda
(MSU) and EGPAF coordinate their
activities to provide FP to HIV
clients at publi...
USAID/Ethiopia
(Below) PEPFAR-supported
HIV NGO clinic providing FP
services in Addis Ababa,
including to ~200 sex workers...
USAID/Tanzania
Comprehensive group counseling at
Marie Stopes Tanzania mobile clinical
outreach site, includes HCT service...
USAID/South Africa
One-stop shop integrated FP and
HIV services in primary and
community health centers
USAID/Lesotho
Community based HIV activities with
FP integration through village health
workers
USAID/Zambia
Co-location of VMMC, VCT, and FP
services
USAID/Nepal
FP integration for female sex
workers in HIV drop in centers
Community-based FP
education linked to Radio
List...
Promising Practices
Promising practices for improving FP and HIV outcomes
• “One-stop shop” service delivery
• Dedicated F...
Promising Practices (3)
• Integration of FP into PMTCT settings
• FP education in ANC sites
• Provision of post partum fam...
Technical Considerations
• No “one-size fits all” approach; country context important
• FP services in an FP/HIV integrate...
Technical Considerations (2)
• Safe pregnancy services for PLHIV – counseling and care
services should be part of comprehe...
FP/HIV Resources
Technical Brief: Hormonal Contraception and HIV
http://www.usaid.gov/sites/default/files/documents/186
4/...
FP/HIV Resources
• USAID Knowledge for Health (K4Health) FP/HIV Integration Toolkit
https://www.k4health.org/toolkits/fphi...
Thank you for your interest!
For more information on USAID’s FP/HIV Integration
guidance and activities please contact:
Je...
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Ccih 2014-fp-integration-jennifer-mason

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Jennifer Mason, Senior Advisor for FP/HIV Integration for USAID's Office of Population and Reproductive Health describes the agency's approach to integrating family planning services with HIV health services and provides country examples of integration practices.

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Ccih 2014-fp-integration-jennifer-mason

  1. 1. The Nuts and Bolts of FP/HIV Integration: Promising Practices and Technical Considerations Christian Connections for International Health Conference Sunday, June 22, 2014 Jennifer Mason USAID Office of Population and Reproductive Health
  2. 2. Overview of Presentation • USG Rationale and Guiding Principles for FP/HIV • FP/HIV integration approaches and models • Programming considerations for specific populations • Country examples • Promising practices • Technical Considerations • Resources
  3. 3. Why Support FP/HIV Integration? FP/HIV Integration assists the US Government to: • Meet clients’ rights and needs for comprehensive health services o Access to a full range of FP services and information is critical for individuals to exercise their reproductive health rights. o USG is committed to meeting the reproductive health needs of PLHIV and those at risk of HIV. o Ensure PLHIV have access to family planning counseling and services and safe pregnancy counseling through the integration of FP services into all PEPFAR prevention, care, and treatment programs. • Achieve global FP, HIV and MCH objectives • Leverage USG comparative advantages in FP and HIV • Practice good public health by using evidence based approaches to achieve improved health outcomes through FP and HIV platforms
  4. 4. 1. HIV-positive individuals should be provided with information on, and be able to exercise voluntary choices about their health, including their reproductive health. 2. The USG, including PEPFAR, supports a person‘s right to choose, as a matter of principle, the number, timing, and spacing of their children, as well as use of family planning methods, regardless of HIV/AIDS status. 3. Family planning use should always be a choice, made freely and voluntarily, independent of the person‘s HIV status. 4. The decision to use or not to use family planning should be free of any discrimination, stigma, coercion, duress, or deceit and informed by accurate, comprehensible information and access to a variety of methods. 5. Access to and provision of health services, including antiretroviral treatment, for an HIV-positive person should never be conditioned on that person's choice to accept or reject any other service, such as family planning (other than what may be necessary to ensure the safe use of antiretroviral treatment). 6. HIV-positive women who wish to have children should have access to safe and non- judgmental pregnancy counseling services. Guiding Principles for USG FP/HIV Programs
  5. 5. USG Interagency Activities • Established the USG Interagency FP/HIV Task Force • 2013-2014 PEPFAR FP/HIV Acceleration Initiative o $25M for five countries: Malawi, Nigeria, Tanzania, Uganda, Zambia o $1.97M for headquarters country support and evaluation activities • Develop technical resources and programming guidance and tools • Provides technical assistance to USAID, CDC and DoD FP/HIV programs
  6. 6. FP/HIV integration approaches and models • FP/HIV integration service delivery platforms include • HIV • Family Planning • Maternal Child Health • Models of integrated FP and HIV services: o Co-located services at the same service delivery point - one provider (e.g. HIV provider counsels and provides FP methods) o Referrals within same health facility - multiple providers (e.g. internal referral system within same service delivery site) o External referral network between health facilities • Health Systems Strengthening • Supply chain, training, enabling environment activities • Social Behavior Change Communication • Community engagement and demand generation
  7. 7. Health Systems Strengthening Health Systems Strengthening Community engagement Community engagement PMTCT Option B+ FP MCH HIV/AIDS FP services ART HCT Prevention HBC VMCC Safe pregnancy services
  8. 8. Programming for Specific Populations • Women of reproductive age • PLHIV • Other women at risk of HIV • Key populations • Sex workers • Female drug users • Youth • Couples • Sero discordant couples • Male engagement
  9. 9. USAID/Uganda (Below) Marie Stopes Uganda (MSU) and EGPAF coordinate their activities to provide FP to HIV clients at public health centers. (Above) Women and men attend group counseling together to receive healthy behavior messages, including FP and VMMC.
  10. 10. USAID/Ethiopia (Below) PEPFAR-supported HIV NGO clinic providing FP services in Addis Ababa, including to ~200 sex workers that live near the clinic.
  11. 11. USAID/Tanzania Comprehensive group counseling at Marie Stopes Tanzania mobile clinical outreach site, includes HCT services (Above) Mobile outreach to rural communities by nurse midwives through bajajis
  12. 12. USAID/South Africa One-stop shop integrated FP and HIV services in primary and community health centers
  13. 13. USAID/Lesotho Community based HIV activities with FP integration through village health workers
  14. 14. USAID/Zambia Co-location of VMMC, VCT, and FP services
  15. 15. USAID/Nepal FP integration for female sex workers in HIV drop in centers Community-based FP education linked to Radio Listeners Group FP integration in home based care for PLHIV
  16. 16. Promising Practices Promising practices for improving FP and HIV outcomes • “One-stop shop” service delivery • Dedicated FP providers in HIV sites • Facilitated referrals • Sensitizing FP providers to PLHIV and Key Population needs • Integrated community health outreach • HIV CHWs delivering ART and FP • FP CBDs providing VCT • Community based activities • Demand generation for FP integrated with HIV communication efforts • FP integration into home based care for PLHIV • Integrating FP services into existing Key Populations platforms • Training HIV providers to act as FP Champions
  17. 17. Promising Practices (3) • Integration of FP into PMTCT settings • FP education in ANC sites • Provision of post partum family planning for PLHIV • Utilizing Option B+ platform to maximize window of opportunities for FP counseling and method provision • Integration of FP into HIV treatment settings • Provision of FP services, including methods • Designated FP provider model for high volume sites • Integration of FP into VMMC settings • Sensitizing males to FP • Leverage resources to expand FP information and counseling • Supply Chain • Integrating FP and HIV supply chains systems and LMIS • Monitoring and Evaluation • Integrating FP indicators into HIV HMIS to capture achievements and have better FP data on PLHIV
  18. 18. Technical Considerations • No “one-size fits all” approach; country context important • FP services in an FP/HIV integrated site should be of the same quality as in a traditional FP/RH services. • Provision of FP methods is not the always the best approach; consider referrals • Ensure programmatic activities are in line with USG compliance requirements • QUALITY OF CARE! • Ensuring method mix (especially LARCs) • Informed choice for PLHIV • Strengthen post partum FP within PMTCT • Ensure that FP is part of the key population prevention and continuum of care package
  19. 19. Technical Considerations (2) • Safe pregnancy services for PLHIV – counseling and care services should be part of comprehensive FP/HIV integration package • Consider FP integration in design and roll out of Option B+ • VMMC – is VMMC a good integration platform? • Consider HC-HIV issues • Consider the costs of integrated services • Ensure availability of FP commodities in HIV settings as needed • Track FP outcomes in HIV sites
  20. 20. FP/HIV Resources Technical Brief: Hormonal Contraception and HIV http://www.usaid.gov/sites/default/files/documents/186 4/hormonal-contraception-and-HIV.pdf Integrating FP into HIV Programs: Evidence-Based Practices http://www.fhi360.org/resource/integrating-family- planning-hiv-programs-evidence-based-practices
  21. 21. FP/HIV Resources • USAID Knowledge for Health (K4Health) FP/HIV Integration Toolkit https://www.k4health.org/toolkits/fphivintegration • From Roots to Results: Evidenced Based Practices for Integrating FP into HIV http://prezi.com/mwk7mypyw9q7/integrating-family-planning-into-hiv-programs/ • The Balanced Counseling Strategy Plus (BCS+): A Toolkit for FP Service Providers Working in High HIV/STI Prevalence Settings: http://www.k4health.org/toolkits/sdm/balanced-counseling-strategy-toolkit-family- planning-service-providers • Reproductive Choices and Family Planning for People Living with HIV: a counseling tool developed by the World Health Organization to help health care workers counsel women and men living with HIV and their partners on sexual and reproductive choices and family planning. http://apps.who.int/iris/bitstream/10665/43609/1/9241595132_eng.pdf • USAID FP/HIV integration website: http://www.usaid.gov/what-we-do/global- health/hiv-and-aids/technical-areas/promoting-integration-family-planning-hiv-and AIDS Supplement “Family Planning and HIV”. 2013 http://journals.lww.com/aidsonline
  22. 22. Thank you for your interest! For more information on USAID’s FP/HIV Integration guidance and activities please contact: Jennifer Mason- USAID Office of Population and Reproductive Health jmason@usaid.gov Nithya Mani- USAID Office of HIV/AIDS nmani@usaid.gov

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