Focus on Women: Linking HIV Care and Treatment with Reproductive Health Services in the MTCT-Plus Initiative

2005 ◽  
Vol 13 (25) ◽  
pp. 136-146 ◽  
Author(s):  
Landon Myer ◽  
Miriam Rabkin ◽  
Elaine J Abrams ◽  
Allan Rosenfield ◽  
Wafaa M El-Sadr
2021 ◽  
Vol 3 ◽  
Author(s):  
Sarah Lawrence ◽  
Hellen Moraa ◽  
Kate Wilson ◽  
Immaculate Mutisya ◽  
Jillian Neary ◽  
...  

Background: To improve holistic care for adolescents living with HIV (ALHIV), including integration of sexual and reproductive health services (SRHS), the Kenya Ministry of Health implemented an adolescent package of care (APOC). To inform optimized SRH service delivery, we sought to understand the experiences with SRHS for ALHIV, their primary caregivers, and health care workers (HCWs) following APOC implementation.Methods: We completed a mixed methods evaluation to characterize SRHS provided and personal experiences with access and uptake using surveys conducted with facility managers from 102 randomly selected large HIV treatment facilities throughout Kenya. Among a subset of 4 APOC-trained facilities in a high burden county, we conducted in-depth interviews (IDIs) with 40 ALHIV and 40 caregivers of ALHIV, and 4 focus group discussions (FGDs) with HCWs. Qualitative data was analyzed using thematic analysis. Facility survey data was analyzed using descriptive statistics.Results: Of 102 surveyed facilities, only 56% reported training in APOC and 12% reported receiving additional adolescent-related SRHS training outside of APOC. Frequency of condom provision to ALHIV varied, with 65% of facilities providing condoms daily and 11% never providing condoms to ALHIV. Family planning (FP) was provided to ALHIV daily in 60% of facilities, whereas 14% of facilities reported not providing any FP services to ALHIV. Screening and treatment for STIs for adolescents were provided at all clinics, with 67% providing STI services daily. Three key themes emerged characterizing experiences with adolescent SRHS access and uptake: (1) HCWs were the preferred source for SRH information, (2) greater adolescent autonomy was a facilitator of SRH discussions with HCWs, and (3) ALHIV had variable access to and limited uptake of SRHS within APOC-trained health facilities. The primary SRHS reported available to ALHIV were abstinence and condom use education. There was variable access to FP, condoms, pregnancy and STI testing, and partner services. Adolescents reported limited utilization of SRHS beyond education.Conclusions: Our results indicate a gap in SRHS offered within APOC trained facilities and highlight the importance of adolescent autonomy when providing SRHS and further HCW training to improve SRHS integration within HIV care for ALHIV.


AIDS Care ◽  
2008 ◽  
Vol 20 (10) ◽  
pp. 1217-1223 ◽  
Author(s):  
Phyllis Orner ◽  
Diane Cooper ◽  
Landon Myer ◽  
Virginia Zweigenthal ◽  
Linda-Gail Bekker ◽  
...  

2020 ◽  
Vol 8 ◽  
pp. 95-108
Author(s):  
Shanti Prasad Khanal

 The present study aims to examine the multi-level barriers to utilize by the youth-friendly reproductive health services (YFRHS) among the school-going youths of the Surkhet valley of Nepal. This study is based on the sequential explanatory research design under mixed-method research. The quantitative data were collected using the self- administered questionnaire from the 249 youths, aged between the 15-24 years, those selected by using random sampling. The qualitative data were collected using the Focus Group Discussions (FGDs) from the 12 participants who were selected purposively. The study confirmed that school-going youths do not have appropriate utilization of YFHS due to multi-layered barriers. However, the utilization of the service was higher among females, those the older age group, studying in the upper classes, the upper castes, and married youths. The key findings and themes are recognized as multi-layered barriers including personal-level, health system-level, community-level, and policy-level on the entire socio-ecological field. Among them, the existing health system is the foremost barrier. Multi-level interventions are, therefore, required to increase the YFRHS utilization and improve concerns for school-going-youths.  


2020 ◽  
Vol 4 (1) ◽  
pp. 41-62
Author(s):  
D. N. Parajuli

 Reproductive rights are fundamental rights and freedoms relating to reproduction and reproductive health that vary amongst countries around the world, but have a commonality about the protection, preservation and promotion of a woman‘s reproductive health rights. Reproductive rights include the right to autonomy and self-determination , the right of everyone to make free and informed decisions and have full control over their body, sexuality, health, relationships, and if, when and with whom to partner, marry and have children , without any form of discrimination, stigma, coercion or violence. The access and availability of reproductive health services are limited due to geography and other issues, non-availability and refusal of reproductive health services may lead to serious consequences. The State need to ensure accessibility, availability, safe and quality reproductive health services and address the lifecycle needs of women and girls and provide access of every young women and girls to comprehensive sexuality education based on their evolving capacity as their human rights, through its inclusion and proper implementation in school curriculum, community-based awareness program and youth led mass media. It is necessary for strengthening compliance, in a time-bound manner, with international human rights standards that Nepal has ratified that protect, promote, and fulfill the basic human rights and reproductive health rights in Nepal and also need to review standards and conventions that Nepal has had reservations about or those that have been poorly implemented in the country.


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