The Government of Malawi’s Health Sector Strategic Plan II highlights the importance of service integration; however, in practice, this has not been fully realized. We conducted a mixed methods evaluation of efforts to systematically implement integrated family planning and immunization services i...n all health facilities and associated community sites in Ntchisi and Dowa districts during June 2016–September 2017. Methods included secondary analysis of service statistics (pre- and postintervention), focus group discussions with mothers and fathers of children under age one, and in-depth interviews with service providers, supervisors, and managers. Results indicate statistically significant increases in family planning users and shifts in use of family planning services from health facilities to community sites. The intervention had no effect on immunization doses administered or dropout rates. According to mothers and fathers, benefits of service integration included time savings, convenience, and improved understanding of services. Provision and use of integrated services were affected by availability of human resources and commodities, community linkages, data collection procedures and availability, sociocultural barriers, organization of services, and supervision and commitment of health surveillance assistants. The integration approach was perceived to be feasible and beneficial by clients and providers.
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Extract from report of GACVS meeting of 29-30 November 2006, published in the WHO Weekly Epidemiological Record of 19 January 2007
Policy Brief, Updated in March 2017
Key messages
• Meaningful involvement of sex workers in the HIV response through peer-based education and outreach and consultation in policy making and programme planning is vital to reduce their vulnerability to HIV and other sexually transmitted inf...ections (STIs) and ensure that the challenges they face are addressed adequately.
• Sex workers (female, transgender and male) have the right to protect their health through accessing comprehensive and evidence-informed HIV and sexual and reproductive health (SRH) interventions.
• Innovative HIV prevention strategies and creative use of combination interventions are needed to reach mobile and ”hard to reach” sex workers.
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The information provided here can be used to understand the current situation, increase attention to preterm births in Rwanda and to inform dialogue and action among stakeholders. Data can be used to identify the most important risk factors to target and gaps in care in order to identify and impleme...nt solutions for improved outcomes.
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DHS Working Papers No. 92