The tool, which has been piloted in Zambia and Tanzania, assesses the extent to which HIV prevention and treatment service are integrated in our sexual and reproductive health (SRH) services.
Read more about the partnership between Marie Stopes International and the International HIV/AIDs Alliance.
Why integrate SRH and HIV?
Poor sexual reproductive health and HIV infection share many root causes in poverty, gender inequality, stigma and cultural norms. Family planning and HIV programmes also share many desired outcomes in dual protection, the promotion of sexual and reproductive health and human rights for all, and a reduction in maternal, newborn and child mortality.
Integrated sexual reproductive health and HIV services make sense.
Heidi Quinn, Technical Advisor for the Strengthening International Family Planning Organizations (SIFPO) project at Marie Stopes International said: “By linking HIV and sexual and reproductive health services we can reduce vulnerability to HIV, reduce sexually transmitted infections, and provide men and women with HIV prevention information and family planning.”
“That’s why the partnership between the Alliance and Marie Stopes International is so important.”
The partnership was launched in recognition of the fact that the international community needs to accelerate progress on access to integrated reproductive, maternal, newborn and child health services and make more effective the global response to the HIV epidemic, if we are to achieve Millennium Development Goals 4, 5 and 6.
A self-assessment tool
Thanks to the USAID-funded SIFPO project, the Alliance has successfully developed and tested a self-assessment checklist in Marie Stopes International’s Zambia and Tanzania country programmes, which can eventually be rolled out across our network.
Divya Bajpai, Senior Advisor on SRH at the Alliance said: “The new tool measures the current level of HIV integration in Marie Stopes International’s sexual and reproductive health services, and allows staff to develop appropriate actions based on the assessment results.”
The self-assessment tool aims to assess:
- readiness to integrate services at different levels, including the support office and various delivery points
- type and coverage of HIV services, where these have been integrated already
- quality of integrated services, from the perspective of clients and providers
The tool enables us to better understand our current service delivery model, and plan how to increase the coverage and quality of integrated services. It would be used initially to understand the current situation, but can then be repeated to review progress and used as part of an ongoing system for monitoring integration and quality programming.
Pilot results in Zambia and Tanzania
The Alliance has conducted assessment visits to Marie Stopes International’s Zambia and Tanzania programmes. They visited country offices, clinics, mobile outreach teams, members of the community and clients. They also met with representatives of the National AIDS Commission (NAC) and other local partners.
In both countries, the Alliance found that HIV interventions were happening at different entry points within our services, but that these were not standardised or consistent.
In Tanzania, the Alliance met Zawadi, one of our nurse midwives who is one of two team members trained to drive a ‘bajaji’ or motor rickshaw in Zanzibar. The bajiji also serves as a mobile clinic providing family planning information and contraceptives to vulnerable and hard to reach communities on the island.
Divya Bajpai, who conducted the assessment, said: “We discovered that Zawadi is already providing referrals for testing for HIV and other sexually transmitted infections, and for Prevention of Mother to Child Transmission in order to support clients and ensure relevant follow-up within the community.”
“Zawadi identified that she needed more training and support around HIV and AIDS, as well as organisational support in the form of greater monitoring and supervision, and a clear strategy to help her to integrate HIV and SRH services more systematically.”
“Overall, we found that Marie Stopes International staff were committed to integration and wanted to do more at country office and clinical level.”
There were a number of recommendations, including:
- ensure clear quality indicators to measure and monitor integration
- provide training in HIV and stigma reduction within various Marie Stopes International delivery channels
- ensure there are regular supplies of HIV test kits and condoms, along with integrated SRH / HIV messaging within Marie Stopes International’s information and education campaign materials
- ensure safer sex counselling, condom demonstrations and dual protection for all family planning clients
- expand the role of community outreach workers to enable them to refer women to health settings
To find out more about the self-assessment tool being developed for Marie Stopes International country programmes, contact Divya Bajpai or Heidi Quinn. The tool will be finalised in 2012.
For more information about the Alliance’s work on sexual and reproductive health, rights and HIV linkages, download this new Good Practice Guide.
To read more about Marie Stopes International’s work in countries most affected by HIV/AIDS visit www.mariestopes.org