scholarly journals Addressing broader reproductive health needs of female sex workers through integrated family planning/ HIV prevention services: A non-randomized trial of a health-services intervention designed to improve uptake of family planning services in Kenya

PLoS ONE ◽  
2019 ◽  
Vol 14 (7) ◽  
pp. e0219813 ◽  
Author(s):  
Lisa Dulli ◽  
Samuel Field ◽  
Rose Masaba ◽  
John Ndiritu
Author(s):  
Shireen Parker ◽  
Vera Scott

Background: The United Nations Political Declaration on HIV and AIDS of 2006 stressed the need to strengthen policy and programme linkages between HIV and Sexual and Reproductive Health (SRH). However, the effectiveness and best practices for strengthening SRH and HIV linkages are poorly researched in the context of family-planning services. In Cape Town, HIV-prevention services have been integrated into family-planning services. There are two models of service configuration: dedicated stand-alone reproductive health clinics and family planning services located in comprehensive primary-care facilities.Objective: To describe how reproductive health services are integrating HIV prevention and care strategies and to measure the coverage and quality of these integrated services.Methods: A cross-sectional study was conducted using structured interviews with facility managers; a facility-based checklist; and a patient record review to assess the availability of resources, training, access, quality and integration.Results: Facilities in Cape Town are equipped adequately to offer integrated HIV-prevention and SRH services. Overall there was poor coverage of integrated services with 54% of family planning clients having a known HIV status; 47% being screened for a sexually transmitted infection and 55% being offered HIV counselling and testing and receiving condoms. Quality and continuity of care seemed better at the dedicated clinics than at the comprehensive facilities,supported by better training coverage.Conclusion: Engaging middle-level management is crucial with regard to improving integration within a well-resourced setting.


2014 ◽  
Vol 12 (2) ◽  
pp. 42-46
Author(s):  
Khadga Bahadur Shrestha

Transforming family planning rights into practices is not an easy task especially in a developing nation like Nepal where society is patriarchal and literacy is low. Besides, coverage and quality of reproductive health services and active involvement of the community is crucial in the transformation. For properly addressing these challenges, all the sectors that provide family planning services need to act on advocacy, creating demand, reshaping service delivery, sustainability (financial and self-reliance) and high level political and financial commitments are necessary.DOI: http://dx.doi.org/10.3126/hprospect.v12i2.9874 Health Prospect Vol.12(2) 2013: 42-46


2018 ◽  
Vol 12 (4) ◽  
pp. 1074-1083 ◽  
Author(s):  
Megan Hamm ◽  
Elizabeth Miller ◽  
Lovie Jackson Foster ◽  
Mario Browne ◽  
Sonya Borrero

Despite demonstrable need, men’s utilization of sexual and reproductive health services remains low. This low utilization may particularly affect low-income men, given the disproportionate prevalence of unintended pregnancy in low-income populations. Bolstering men’s utilization of sexual and reproductive health services requires understanding the services that are most relevant to them. Semistructured interviews about fatherhood, fertility intention, and contraceptive use were conducted with 58 low-income Black and White men in Pittsburgh, Pennsylvania. The interviews were analyzed using content analysis to determine common themes that were most relevant to the men interviewed. The primacy of financial stability emerged as a dominant theme in men’s perceptions of fatherhood readiness, successful fathering, and fertility intentions. However, men had children despite feeling financially unprepared, and their contraceptive use was not always congruent with their stated fertility intentions. Some men described financial services as a feature of family planning services that they would find useful. Because of the salience of financial stability in preparation for fatherhood, integrating financial counseling and job skills training into the context of sexual and reproductive health services could be a useful structural intervention to increase men’s use of family planning services and to provide them with the support they say they need as fathers.


2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Stewart Britten ◽  
Wahida Paikan

Reduction of child mortality while coverage of family planning services remains low may render Afghanistan a testing ground for the theory of demographic transition. Meanwhile there is a vicious circle: young men lacking employment join the Taliban and so increase national insecurity, discouraging industry and reducing employment opportunities. For progress towards peace to be made and sustained, family planning, education and employment need to be major parts of the peace effort, and UN reports need to emphasise more which way the scales tip.


PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250024
Author(s):  
Natasha Blumer ◽  
Lisa M. Pfadenhauer ◽  
Jacob Burns

The provision of comprehensive prevention services is vital for reducing the high burden of HIV amongst Ukrainian female sex workers (FSWs). To identify barriers and facilitators that influence access to HIV prevention amongst this population between 2009 and 2017, we developed a literature-informed conceptual framework and conducted a document analysis to identify the components of the Ukrainian prevention package (PP). Using the Integrated Bio Behavioural Surveillance Surveys, we then conducted descriptive analyses to explore PP coverage from 2009 to 2017 and the influence of factors, identified by our conceptual framework. After increasing over four years, a drop in PP coverage was observed from 2013 onwards. Being a client of a non-governmental organisation, street and highway solicitation, non-condom use, and knowledge of HIV may influence access to HIV prevention in the Ukrainian context. Future interventions should consider barriers and facilitators to HIV prevention and the multiple structural levels on which they operate.


2019 ◽  
Vol 3 ◽  
pp. 1505 ◽  
Author(s):  
Dismas Oketch ◽  
Eunice C. Kaguiri ◽  
Joseph O. Orinda ◽  
Grace Mboya ◽  
Phoebe Ogutu ◽  
...  

Background: Globally about 210 million women conceive annually and 38% of these pregnancies are unintended. Female sex workers (FSWs) are at increased risk of both unintended pregnancy and acquiring HIV, which could lead to adverse sexual and reproductive health (SRH) outcomes. We sought to assess contraceptive use or non-use, preferences and determinants among a cohort of FSWs screened for an HIV prevention clinical trial in Kisumu, Kenya. Methods: A cross sectional study of healthy FSWs referred for possible recruitment into the Antibody Mediated HIV Prevention (AMP) Study was conducted between December 2016 and September 2018. Potentially eligible participants were screened for HIV and data on social-demographic, contraceptive use and other SRH characteristics were collected. Those not on a method recorded their contraceptive preferences.   Results: Data on 210 FSWs with a median age of 24.5 years (interquartile range, IQR 22-26) are presented. Of these, 187 (89.1%) had two children or fewer; only 56 (26.7%) had completed secondary or higher education. At the time of the interview, 18 (8.6%) were HIV-infected and 181 (86.2%) were using a modern contraceptive. Implants (48.6%) and depot injections (37.6%) were the most commonly used methods. Most (41.4%) of those not on family planning preferred oral pills. Respondents who had two or more children were three times more likely than their primiparous and nulliparous counterparts to report use of a contraceptive. Use of modern contraception methods did not differ by respondent’s ownership of a medical insurance cover or other occupation. Conclusion: There is high use of modern contraception among FSWs in Kisumu with the majority using subdermal implants. Reproductive health programs should implement targeted SRH interventions for specific populations and risk groups. Effective contraceptive counselling and interventions among FSWs should consider the client’s parity and level of education.


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