Feasibility and effectiveness of integrating provider-initiated testing and counselling within family planning services in Kenya

Liambila, Wilson; Askew, Ian; Mwangi, J.; Ayisi, Robert; Kibaru, Josephine; Mullick, Saiqa

doi:10.1097/01.aids.0000363784.96321.43

Cited by 40 publications

(48 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our findings are consistent with the evidence base on facility-based FP/HIV African Journal of Reproductive Health June 2017; 21 (2): 79 integration models, which shows that linkages between FP and HTC can facilitate HTC uptake 3,21 , and also indicates improvements in contraceptive use through various combinations of FP and HIV services 3,4 . Although somewhat limited, the available literature does not provide evidence of negative effects from potentially increased staff time with clients as a result of integrating services, and effects on the quality of FP counseling when adding HTC are reported as positive or mixed 3,21 . The challenges we observed with the delivery of integrated messages echo process evaluation data from several studies on facility-based integration of FP into HIV services, which showed that provision of contraceptive counseling, while improved, was not systematic and was in some cases lower than expected 4 .…”

Section: Discussionsupporting

confidence: 88%

Integrating Family Planning and HIV Services at the Community Level: Formative Assessment with Village Health Teams in Uganda

Brunie

Mucheri²,

Akol³

et al. 2017

Afr J Reprod Health

View full text Add to dashboard Cite

Little is known on integrating HIV and family planning (FP) services in community settings. Using a cluster randomized controlled design, we conducted a formative assessment in two districts in Uganda where community health workers, called VHTs, already offered FP. Thirty-six trained VHTs also provided HIV testing and counseling (HTC) during the intervention. We surveyed all 36 VHTs and 256 FP clients, and reviewed service statistics. In the intervention group, VHTs tested 80% of surveyed clients for HIV, including 76% they already saw for FP and 22% who first came to them for HTC before receiving FP. Comparing clients' experiences in the intervention and control groups, adding HTC does not appear to have negatively affected FP service quality. VHTs reported more monthly clients, but rated their workload as easy to manage. This integrated model seems feasible and beneficial for both VHTs and clients, while not resulting in any negative effects. This study was registered with ClinicalTrials.gov, number [NCT02244398]. (Afr J Reprod Health 2017; 21[2]: 73-80).Keywords: family planning, HIV, community health workers, integration, Uganda RésuméPeu d'informations sont disponibles sur l'intégration des services de planification familiale (PF) et du VIH dans les milieux communautaires. En utilisant un plan randomisé contrôlé par grappes, nous avons mené une évaluation formative dans deux districts en Ouganda dans lesquels les agents de santé communautaire qui sont appelés VHT offraient déjà des services de PF. Trente-six VHT formés ont également fourni des services de conseil et dépistage du VIH (CDV). Nous avons enquêté les 36 ASC et 256 clientes PF, et nous avons examiné les statistiques sur les services. Dans le groupe d'intervention, les VHT ont testé 80% des clients enquêtées pour le VIH, y compris 76% que les VHT voyaient déjà pour la PF et 22% qui sont d'abord venus pour le CDV avant avant de recevoir la PF. En comparant les expériences des clientes dans les groupes avec et sans intervention, l'ajout du CDV ne semble pas avoir affecté négativement la qualité des services PF. Les VHT ont signalé plus de clients mensuellement, mais ont évalué leur charge de travail comme étant aussi facile à gérer. Ce modèle intégré semble faisable et bénéfique pour les VHT et les clients, et sans entraîner d'effet négatif. Cette étude a été enregistrée auprès de ClinicalTrials.gov, numéro [NCT02244398]. (Afr J Reprod Health 2017; 21[2]: 73-80).

show abstract

Section: Discussionsupporting

confidence: 88%

Integrating Family Planning and HIV Services at the Community Level: Formative Assessment with Village Health Teams in Uganda

Brunie

Mucheri²,

Akol³

et al. 2017

Afr J Reprod Health

View full text Add to dashboard Cite

show abstract

“…17,18 Studies of FP/HIV integration demonstrate acceptability to both patients and providers. [19][20][21] Some cohort studies have documented that integrated services can decrease pregnancy rates 22 and increase uptake of hormonal contraceptive methods. 23,24 Most recently, the first cluster-randomized trial (CRT) of integrating FP into routine HIV care services, conducted in western Kenya, demonstrated an increase in more effective contraception use, from 17% at baseline to 37% one year after integration in the intervention arm.…”

mentioning

confidence: 99%

HIV-Positive Men's Experiences with Integrated Family Planning and HIV Services in Western Kenya: Integration Fosters Male Involvement

Patel

Baum²,

Grossman

et al. 2014

AIDS Patient Care and STDs

View full text Add to dashboard Cite

A growing body of evidence indicates that integrating family planning (FP) services into HIV care is effective at improving contraceptive uptake among HIV-positive women in resource-poor settings, yet little research has examined HIV-positive men's experiences with such integration. We conducted in-depth interviews with 21 HIV-positive men seeking care at HIV clinics in Nyanza, Kenya. All clinics were intervention sites for a FP/ HIV service integration cluster-randomized trial. Grounded theory was used to code and analyze the data. Our findings highlight men's motivations for FP, reasons why men prefer obtaining their FP services, which include education, counseling, and commodities, at HIV care clinics, and specific ways in which integrated FP/HIV services fostered male inclusion in FP decision-making. In conclusion, men appear invested in FP and their inclusion in FP decision-making may bolster both female and male agency. Men's positive attitudes towards FP being provided at HIV care clinics supports the programmatic push towards integrated delivery models for FP and HIV services.

show abstract

“…demonstrated the effectiveness of at risk communication at recruiting at risk groups to utilize reproductive and preventative health care [38]. Several studies demonstrate the effectiveness of Youth Peer Education services at referring at risk populations to appropriate clinics [23,13]. When coupled with a voucher system for care, use of clinics increases dramatically [9].…”

Section: Discussionmentioning

confidence: 99%

Online Promiscuity: Prophylactic Patching and the Spread of Computer Transmitted Infections

Kelley

Camp

2013

The Economics of Information Security and Privacy

View full text Add to dashboard Cite

There is a long history of studying the epidemiology of computer malware. Much of this work has focused on the behaviors of specific viruses, worms, or botnets. In contrast, we seek to utilize an extension of the simple SIS model to examine the efficacy of various aggregate patching and recovery behaviors. We use the SIS model because we are interested in global prevalence of malware, rather than the dynamics, such as recovery, covered in previous work. We consider four populations: vigilant and non-vigilant with infected or not for both sets. We show, using our model and a real world data set, that small increases in patch rates and recovery speed are the most effective approaches to reduce system wide vulnerabilities due to unprotected computers. Our results illustrate that a public health approach may be feasible, as what is required is that a subpopulation adopt prophylactic actions rather than near-universal immunization.

show abstract

Feasibility and effectiveness of integrating provider-initiated testing and counselling within family planning services in Kenya

Abstract: Provider-initiated testing and counselling is feasible and acceptable in family planning services, does not adversely affect the quality of the family planning consultation and increases access to and use of HIV testing in a population who would benefit from knowing their status.

Cited by 40 publications

References 3 publications

Integrating Family Planning and HIV Services at the Community Level: Formative Assessment with Village Health Teams in Uganda

Integrating Family Planning and HIV Services at the Community Level: Formative Assessment with Village Health Teams in Uganda

HIV-Positive Men's Experiences with Integrated Family Planning and HIV Services in Western Kenya: Integration Fosters Male Involvement

Online Promiscuity: Prophylactic Patching and the Spread of Computer Transmitted Infections

Contact Info

Product

Resources

About