Integrating HIV Prevention in Reproductive Health Settings

Me, Zotti; Pringle, John; Stuart, Gretchen S.; Wa, Boyd; Brantley, David; L, de Ravello

doi:10.1097/phh.0b013e3181ef1935

Cited by 8 publications

(10 citation statements)

References 9 publications

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“…However, reports of integration benefits represent positive provider perceptions about how well a new system is performing and these perceptions should be taken seriously and seized upon. Perceptions drive provider behaviour, which is central to the long term success of change and integration [11,20]. …”

Section: Discussionmentioning

confidence: 99%

“…Once these have been addressed and the transformation accomplished, a subsequent focus should be on how to manage the post-change phase to ensure sustainability of the transformation. Previous work has noted the importance of commensurate staff incentives and benefits ‘packages’ [9,12,25] and that good management of the transformation process is key to sustaining successful change [11,12,26] and effective delivery of health services after transformation [14,21]. …”

Section: Discussionmentioning

confidence: 99%

“…As Zotti et al [11] observe, employee behaviour is central to organisational change and ultimately determines the outcome of any change process. Generally, there are two possible levels at which providers behavioural responses to integration may be influenced.…”

Section: Introductionmentioning

confidence: 99%

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Experiences of health care providers with integrated HIV and reproductive health services in Kenya: a qualitative study

Mutemwa

Mayhew

Colombini

et al. 2013

BMC Health Serv Res

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BackgroundThere is broad consensus on the value of integration of HIV services and reproductive health services in regions of the world with generalised HIV/AIDS epidemics and high reproductive morbidity. Integration is thought to increase access to and uptake of health services; and improves their efficiency and cost-effectiveness through better use of available resources. However, there is still very limited empirical literature on health service providers and how they experience and operationalize integration. This qualitative study was conducted among frontline health workers to explore provider experiences with integration in order to ascertain their significance to the performance of integrated health facilities.MethodsSemi-structured in-depth interviews were conducted with 32 frontline clinical officers, registered nurses, and enrolled nurses in Kitui district (Eastern province) and Thika and Nyeri districts (Central province) in Kenya. The study was conducted in health facilities providing integrated HIV and reproductive health services (post-natal care and family planning). All interviews were conducted in English, transcribed and analysed using Nvivo 8 qualitative data analysis software.ResultsProviders reported delivering services in provider-level and unit-level integration, as well as a combination of both. Provider experiences of actual integration were mixed. At personal level, providers valued skills enhancement, more variety and challenge in their work, better job satisfaction through increased client-satisfaction. However, they also felt that their salaries were poor, they faced increased occupational stress from: increased workload, treating very sick/poor clients, and less quality time with clients. At operational level, providers reported increased service uptake, increased willingness among clients to take an HIV test, and reduced loss of clients. But the majority also reported infrastructural and logistic deficiencies (insufficient physical room space, equipment, drugs and other medical supplies), as well as increased workload, waiting times, contact session times and low staffing levels.ConclusionsThe success of integration primarily depends on the performance of service providers which, in turn, depends on a whole range of facilitative organisational factors. The central Ministry of Health should create a coherent policy environment, spearhead strategic planning and ensure availability of resources for implementation at lower levels of the health system. Health facility staffing norms, technical support, cost-sharing policies, clinical reporting procedures, salary and incentive schemes, clinical supply chains, and resourcing of health facility physical space upgrades, all need attention. Yet, despite these system challenges, this study has shown that integration can have a positive motivating effect on staff and can lead to better sharing of workload - these are important opportunities that deserve to be built on.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Experiences of health care providers with integrated HIV and reproductive health services in Kenya: a qualitative study

Mutemwa

Mayhew

Colombini

et al. 2013

BMC Health Serv Res

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“…Despite some challenges such as staffing norms, technical support, motivation, infrastructural and logistics inadequacies etcetera were identified, the study showed that integration can serve as source of motivation to personnel leading to sharing of work effort. It was also observed in another study that the behaviour of an employee could be central to an organizational change and ultimately determines the outcome of any change process (Zotti et al, 2010). Hence, providers' behavioural response towards the integration of SRH/HIV services can be influenced at an individual level where individual direct benefits may influence their services delivery and at the operational level where health care providers may experience systemic improvements or challenges that may follow an integrated health service (Dudley & Garner, 2011).…”

Section: Literature Reviewmentioning

confidence: 97%

“…However, provision of integrated care from vertical services is very intricate and requires important adjustments in almost all area of health care by organization carrying out public health interventions. The success of any transformation process and its outcome is dependent on the personnel behaviour (Zotti et al, 2010). Health provider's behaviour towards integration can either be at personal level where they can see integration as an opportunity for professional skills enhancement or a threat to their work (Aschraft & ISSN: 2520-3134 Anthony, 2010) and at operational level where providers may experience systemic improvements or challenges that can affect the delivery of integrated services (Maharaj &Cleland, 2005 andMagwaza, Cooper &Hoffman, 2001).…”

Section: Introductionmentioning

confidence: 99%

Experiences of Health Care Providers with Integrated Sexual Reproductive Health (SRH) and HIV Services in Oyo State

Tomori¹

2017

TIJPH

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Background: There has been wide agreement in some part of the world where there is generalized HIV/AIDS and high reproductive disease incidence that integration of sexual reproductive health (SRH) and HIV services is of great importance. Integration is assume to increase accessibility to and uptake of health services; it also ensures better use of resources as it improves efficiency at cheaper cost. But there are few studies on the significance of health care providers' experiences to the system. This research study was carried out among frontline health personnel to investigate provider experiences on integration to establish their importance to the success of integrated health facilities. Methods: Semi-structured questionnaires were administered with 32 frontline health care providers in some facilities providing integrated SRH and HIV services in Oyo State. The interviews were then transcribed and analyses by the researcher and research assistants. Results: Respondents reported the benefits they are the clients received as a result of integration. Shortage of manpower to carter for increased workload was by far the most obvious challenge facing the health workers. Others included inadequate infrastructure, stock-out of materials, lack of motivation due to untimely payment of salary, gaps in training, language barrier, poverty and misconceptions: Conclusions: The roles of health care providers is very critical to the successful implementation of integrated SRH and HIV services. Their performances can also be affected by some challenges identified in this study. However, this study has shown that integration can assist in ameliorating these identified problems and these valuable opportunities deserves further probing.

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Healthcare workers' perceptions and experiences of primary healthcare integration: a scoping review of qualitative evidence

Moloi

Daniels

Brooke-Sumner

et al. 2023

Cochrane Database of Systematic Reviews

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Integrating HIV Prevention in Reproductive Health Settings

Abstract: RH settings were able to integrate HIV prevention services by employing a systematic process.

Cited by 8 publications

References 9 publications

Experiences of health care providers with integrated HIV and reproductive health services in Kenya: a qualitative study

Experiences of health care providers with integrated HIV and reproductive health services in Kenya: a qualitative study

Experiences of Health Care Providers with Integrated Sexual Reproductive Health (SRH) and HIV Services in Oyo State

Healthcare workers' perceptions and experiences of primary healthcare integration: a scoping review of qualitative evidence

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