scholarly journals Sexual reproductive health service provision to young people in Kenya; health service providers’ experiences

2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Pamela M Godia ◽  
Joyce M Olenja ◽  
Joyce A Lavussa ◽  
Deborah Quinney ◽  
Jan J Hofman ◽  
...  
2019 ◽  
Vol 30 (14) ◽  
pp. 1432-1435
Author(s):  
Eleanor Cochrane ◽  
Carys Knapper

Pre-exposure prophylaxis (PrEP) for HIV in Wales was launched in July 2017. We set up a PrEP service delivered via our integrated sexual reproductive health service in Aneurin Bevan University Health Board (ABUHB), south east Wales. Public Health Wales (PHW) data show a 22% ‘lost to follow-up’ rate amongst Welsh PrEP patients. Over 18 months, 278 patients booked into ABUHB PrEP clinics. Of these, 275 were men who have sex with men (MSM). One hundred and ninety-three patients commenced PrEP, 5 were diagnosed with HIV at baseline, 42 did not attend their first appointment. The remainder declined PrEP. Of those commenced on PrEP, 51.7% had reduced clinic attendances; all were MSM. Patients with reduced attendances were more likely to be younger (mean age 33 vs. 37 years), reside outside ABUHB catchment area (56.4% vs. 49.6%) and have mental health issues (28.6% vs. 18.8%), but were less likely to disclose substance misuse (24.2% vs. 27.1%) than those attending in line with operational guidance. Of the 63 patients who stopped attending the PrEP clinic, 32.3% (21) had documented reasons, the most common being reduced self-perceived risk. This is the first evaluation of reasons why patients stop attending as well as risk factors associated with those lost to follow-up in PrEP services in Wales.


2017 ◽  
Vol 4 (4) ◽  
pp. 248-266 ◽  
Author(s):  
Seare Hadush Desta ◽  
Shaik Yousuf Basha

Health Extension Workers are the health service providers to the community in delivering integrated preventive, promotive and basic curative health services. Hitherto no studies have been carried out in Lim ‘at T’abya health post focusing on the role of health extension workers. Thus the researcher has randomly selected 263 participants in order to achieve the intended objectives of the study. The researcher used both quantitative and qualitative approaches. The result of the study identified the major Health Extension Program services which are delivered by Health Extension Workers in the health post to seek malaria treatment, child immunization and Antenatal Care followed by Postnatal Care, family planning, referral for delivery, diarrhea treatment and health education. The challenges of Health Extension Workers hindering their performance for the unsuccessful health service provision identified as strong societal cultural beliefs, remoteness, poor relation with supervisors, communication system and road construction, low remuneration, lack of refresher courses and improper attention by Qebelle administrators to health agendas. Attitude of community towards Health Extension Workers communication skill, quality of service provision and social behaviors is over all positive but the following up of referred patients and the skill to diagnosing community health problems that Health Extension Workers need to work sensitively which are answered negatively by the respondents. To increase community’s health post utilization, health posts should be equipped with minimum essential medical equipment with particular focus on malaria treatments, family planning, deliver, treatment of common illnesses and immunization services in the study area.Int. J. Soc. Sc. Manage. Vol. 4, Issue-4: 248-266


2018 ◽  
Vol 94 (5) ◽  
pp. 327-330 ◽  
Author(s):  
Carys Knapper ◽  
Humphrey Birley ◽  
Zoe Couzens ◽  
Adam Thomas Jones ◽  
Irene Parker

Pre-exposure prophylaxis for HIV (PrEP) has been shown to reduce transmission of HIV in a number of trials; however, there is limited evidence regarding the optimal way to deliver PrEP through pre-existing UK services, particularly through fully integrated drop-in sexual health service models. PrEP in the form of Truvada was launched in Wales in July 2017. We set up a PrEP service to be delivered via our drop-in integrated sexual reproductive health service. In the first 5 months of PrEP service provision, we found unforeseen levels of comorbidity, polypharmacy and renal impairment in our cohort of PrEP patients. As a result, we have altered our service model and all patients are now followed up in booked appointment PrEP clinics run by members of the HIV team. Those patients with estimated glomerular filtration rate (eGFR) of 60–70 mL/min or with eGFR of 60–80 mL/min and with comorbidities impacting on renal function are monitored every 4–6 weeks initially, and PrEP has been incorporated into our pre-existing virtual HIV renal clinic for discussion with a renal physician. The PrEP team clinicians report that monitoring and managing the PrEP cohort is now easier in its appointment-only format, although some patients have reported that they would prefer a drop-in system.


2018 ◽  
Vol 29 (11) ◽  
pp. 1106-1109 ◽  
Author(s):  
Carys Knapper ◽  
Humphrey Birley ◽  
Irene Parker

Following the Joint Committee on Vaccination and Immunisation statement in November 2015 advising a human papillomavirus (HPV) vaccination programme targeting men who have sex with men (MSM) up to the age of 45 attending Genitourinary medicine and HIV services, we launched a HPV vaccination programme for MSM to be delivered through our Integrated Sexual Reproductive Health drop-in service across Newport and the South East Wales Valleys from 1 August 2016. Over the first 18 months of the vaccination programme 539 of the 693 (77%) eligible MSM who attended clinics where the vaccine was available commenced vaccination. The vaccination programme appears to have fitted in well with our pre-existing sexual health service delivery model and appears popular with MSM attending the service. We completed the full vaccination course in 40% of MSM who commenced the vaccine with adequate time to complete the schedule within the time frame of the audit. The audit demonstrates that HPV vaccination delivery for MSM is feasible in an Integrated Sexual Reproductive Health service setting.


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