scholarly journals Integrating Sexual and Reproductive Health Services Within HIV Services: WHO Guidance

2021 ◽  
Vol 2 ◽  
Author(s):  
Nathan Ford ◽  
Morkor Newman ◽  
Sarai Malumo ◽  
Lastone Chitembo ◽  
Mary E. Gaffield

Among the 1.9 billion women of reproductive age worldwide in 2019, 1.1 billion need family planning and 270 million have an unmet need for contraception. For women and adolescent girls living with human immunodeficiency virus (HIV), using effective contraception reduces the mother-to-child transmission of HIV by preventing unintended pregnancies and enabling the planning and safer conception of desired pregnancies with optimal maternal and child health outcomes. The World Health Organization (WHO) recommends that sexual and reproductive health services, including contraception, may be integrated within HIV services. Integration is associated with increased offers and uptake of sexual and reproductive health services, including contraception, which is likely to result in improved downstream clinical outcomes. Integrating HIV and sexual and reproductive health services has been found to improve access, the quality of antenatal care and nurse productivity while reducing stigma and without compromising uptake of care. Research is encouraged to identify approaches to integration that lead to better uptake of sexual and reproductive health services, including contraception. Implementation research is encouraged to evaluate different strategies of integration in different health systems and social contexts; such research should include providing contraception, including long-acting contraception, in the context of less frequent clinical and ART refill visits.

2015 ◽  
Vol 3 (2) ◽  
Author(s):  
Doaa Oraby

In 2005, a World Health Organization resolution called for health systems to move towards universal coverage, such that everyone would have access to promotive, preventive, curative and rehabilitative health interventions at an affordable cost. Responding to this call, a new target for achieving universal access to reproductive health was integrated within the revised millennium development goals framework. Forty-eight African countries adopted the Maputo Plan of Action committing to the goal of universal access to comprehensive sexual and reproductive health services in Africa by 2015. The aim of this study was to assess Egypt’s commitment to implementing the Maputo Plan of Action. This was achieved through soliciting information relating to the extent of Egypt’s progress towards the achievement of universal access to sexual and reproductive health and rights information and services. In late 2009, a qualitative study was conducted. It included in-depth interviews with 20 physicians and 10 key informants in addition to 8 focus group discussions with sub-segments of 65 beneficiaries, including married women of reproductive age, married men and youth of both sexes. The study revealed that public sector, non-governmental organisations and private sector organisations delivering sexual and reproductive health services functioned in isolation from each other. Delivered services focused mainly on family planning and maternity care and targeted married women of reproductive age. Scaling up universal access to sexual and reproductive health services requires programmes to expand beyond the maternal and child health delivery model targeted solely at married women with children.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Lesley Rose Ninsiima ◽  
Isabel Kazanga Chiumia ◽  
Rawlance Ndejjo

Abstract Background Despite the global agreements on adolescents’ sexual and reproductive health and rights, access to and utilisation of these services among the youth/adolescents remain unsatisfactory in low- and middle-income countries which are a significant barrier to progress in this area. This review established factors influencing access and utilisation of youth-friendly sexual and reproductive health services (YFSRHS) among the youth in sub-Saharan Africa to inform programmatic interventions. Methodology A systematic review of studies published between January 2009 and April 2019 using PubMed, Web of Science, EMBASE, Medline, and Cochrane Library, and Google Scholar databases was conducted. Studies were screened based on the inclusion criteria of barriers and facilitators of implementation of YFSRHS, existing national policies on provision of YFSRHS, and youth’s perspectives on these services. Findings A total of 23,400 studies were identified through database search and additional 5 studies from other sources. After the full-text screening, 20 studies from 7 countries met the inclusion criteria and were included in the final review. Structural barriers were the negative attitude of health workers and their being unskilled and individual barriers included lack of knowledge among youth regarding YFSRHS. Facilitators of utilisation of the services were mostly structural in nature which included community outreaches, health education, and policy recommendations to improve implementation of the quality of health services and clinics for adolescents/youth to fit their needs and preferences. Conclusion Stakeholder interventions focusing on implementing YFSRHS should aim at intensive training of health workers and put in place quality implementation standard guidelines in clinics to offer services according to youth’s needs and preferences. In addition, educating the youth through community outreaches and health education programs for those in schools can facilitate utilisation and scale up of the service.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Tewachew Muche Liyeh ◽  
Yitayal Ayalew Goshu ◽  
Habtamu Gebrehana Belay ◽  
Habtamu Abie Tasew ◽  
Gedefaye Nibret Mihiretie ◽  
...  

Introduction. Youth is a decisive age to shape the direction of their life and that of their family. However, due to the host of biological, social, and economic factors, adolescent females can be at high risk of adverse sexual and reproductive health outcomes. Therefore, assessing youth reproductive service utilization and associated factors among female night students is very crucial for timely intervention to their gaps. Method. An institutional-based cross-sectional study design was conducted in Amhara region among 2,050 female night students from September 15 to November 15, 2018. A self-administered pretested questionnaire was used to collect the data. Bivariate and multivariable logistic regression models were used. Odds ratio with 95% confidence interval was computed to determine the strength of association between predictor and outcome variables. P value less than or equal to 0.05 is considered as the level of significance. Results. Out of the total respondents, about 54.6%(CI: 52.5%-56.8%) of them utilized reproductive health services. Respondents who were attending secondary education ( AOR = 2.55 , 95 % CI = 1.97 ‐ 5.62 ), attitude towards youth reproductive health services ( AOR = 2.74 , 95 % CI = 2.07 ‐ 5.30 ), those who had a habit of communicating on sexual and reproductive health issues with their family ( AOR = 3.66 , 95 % CI = 3.59 ‐ 7.41 ), discussion on sexual and reproductive health issue with peers/friends ( AOR = 1.43 , 95 % CI = 1.01 ‐ 2.02 ), respondents with good knowledge on youth reproductive health services ( AOR = 2.03 , 95 % CI = 1.49 ‐ 2.75 ), and those who had faced reproductive health problems ( AOR = 2.03 , 95 % CI = 1.49 ‐ 2.75 ) were significantly associated with youth reproductive health service utilization. Conclusion. Youth reproductive health service utilization among female night students was not satisfactory. Therefore, special focus should be given to female night students by providing accessible, acceptable, confidential, flexible, and friendly reproductive health service utilization. Finally, community health promotion and education are mandatory to promote the practice of discussing youth reproductive health issues with their children.


PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0242046
Author(s):  
Jacques B. O. Emina ◽  
Parfait Gahungu ◽  
Francis Iyese ◽  
Rinelle Etinkum ◽  
Brigitte Kini ◽  
...  

Introduction Delivering integrated sexual and reproductive health services (SRHS) in emergencies is important in order to save lives of the most vulnerable as well as to combat poverty, reduce inequities and social injustice. More than 60% of preventable maternal deaths occur in conflict areas and especially among the internally displaced persons (IDP). Between 2016 and 2018, unprecedented violence erupted in the Kasaï’s region, in the Democratic Republic of Congo (DRC), called the Kamuina Nsapu Insurgency. During that period, an estimated three million of adolescent girls and women were forced to flee; and have faced growing threat to their health, safety, security, and well-being including significant sexual and reproductive health challenges. Between August 2016 and May 2017, the “Sous-Cluster sur les violences basées sur le genre (SC-VBG)” in DRC (2017) reported 1,429 Gender Based Violence (GBV) incidents in the 49 service delivery points in the provinces of Kasaï, Kasaï Central and Kasaï Oriental. Rape cases represented 79% of reported incidents whereas sexual assault and forced marriage accounted for respectively 11% and 4% of Gender Based Violence (GBV) among women and adolescent girls. This study aims to assess the availability of SRHS in the displaced camps in Kasaï; to evaluate the SRHS needs of young girls and women in the reproductive age (12–49). Studies of sexual and reproductive health (SRH) in the Democratic Republic of Congo (DRC) have often included adolescent girls under the age of 15 because of high prevalence of child marriage and early onset of childbearing, especially in the humanitarian context. According to the 2013 Demographic and Health Survey (DHS), about 16% of surveyed women got married by age 14 while the prevalence of early child marriage (marriage by 15) was estimated at 30%; to assess the use of SRHS services and identify barriers as well as challenges for SRH service delivery and use. Findings from this study will help provide evidence to inform towards more needs-based and responsive SRH service delivery. This is hoped for ultimately improve the quality and effectiveness of services, when considering service delivery and response in humanitarian settings. Data and methods We will conduct a mixed-methods study design, which will combine quantitative and qualitative approaches. Based on the estimation of the sample size, quantitative data will be drawn from the community-based survey (500 women of reproductive age per site) and health facility assessments will include assessments of 45 health facilities and 135 health providers’ interviews. Qualitative data will comprise materials from 30 Key Informant Interviews (KII) and 24 Focus Group Discussions (FGDs), which are believed to achieve the needed saturation levels. Data analysis will include thematic and content analysis for the KIIs and FGDs using ATLAS.ti software for the qualitative arm. For the quantitative arm, data analysis will combine frequency and bivariate chi-square analysis, coupled with multi-level regression models, using Stata 15 software. Statistic differences will be established at the significance level of 0.05. We submitted this protocol to the national ethical committee of the ministry of health in September 2019 and it was approved in January 2020. It needs further approval from the Scientific Oversee Committee (SOC) and the Provincial Ministry of Health. Prior to data collection, informed consents will be obtained from all respondents.


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