SRH & HIV LINKAGES AND INTEGRATIONProvision of Integrated SRH and HIV services in Malawi Hans Katengeza- MOH,Department of Reproductive Health
Outline of presentation • SRH Services • HIV and AIDS Services • Principles to Consider • Potential Benefits • Key links • Challenges • Critical considerations/questions04/04/2013 2
Always look for opportunities around the Key Linkages compartment Sexual and HIV and Reproductive Health AIDS• Family Planning Key Linkages • HIV and Family • Prevention: Condom• Maternal and Infant Planning Promotion and PMTCT Care including antenatal and • HIV and Reproductive • Diagnosis and postnatal care Health Treatment: VCT, ARVs • HIV and STI control and treatment of OI’s• STI Diagnosis and Treatment • PMTCT and Family • Care: Community Planning, Antenatal home based care• Post-Abortion Care Care, Postnatal Care • Support for PLWHA• Youth-Friendly Services• Counseling
Principles to consider while Linking SRH & HIV/AIDS• Address structural determinants of HIV and SRH (poverty, gender inequality, social marginalization, etc.)• Focus on Human Rights and Gender• Promote a national coordinated and coherent response• Meaningfully involve PLWHA• Foster community participation• Reduce stigma and discrimination
Potential Benefits of Integration of SRH and HIV• Access to services – Improved access to and uptake of key HIV/AIDS and SRH services including the community – Better access by PLWHA to SRH services tailored to their needs – Reduced HIV/AIDS-related stigma and discrimination – Improved coverage of underserved and marginalized populations – Greater support for dual protection – Maximum use of limited resources.
Potential Benefits of Integration of SRH and HIV/AIDS• Service Delivery – Improved quality of care- one stop shop. – Enhanced programme effectiveness and efficiency – Decreased duplication of efforts and competition for resources – Better understanding and protection of individual rights – Mutually reinforcing complementarities in legal and policy frameworks including community intiatives.
Challenges to Integration of SRH and HIV/AIDS• Overburdening existing services (initial phase)• Increased workload for staff• Increased costs initially• Adapting services to attract men and young people• Reaching the most vulnerable people• Special training and ongoing support to staff• Motivating donors to opt for integrated services• Making the services available to the rural communities (Hard to reach areas)
Critical Considerations/Questions to Integration• Which service combinations are feasible?• Which services are acceptable to clients and service providers?• Which services can effectively increase access to one or both without compromising the quality or safety of their delivery• Does joint provision lead to synergistic impact to both the individual client served and that of the community served?• What to integrate at each level? 9