Integration of HIV and SRHR, SAT,

1. SRH & HIV LINKAGES AND
INTEGRATION
Provision of Integrated SRH and HIV
services in Malawi
Hans Katengeza- MOH,
Department of Reproductive Health

2. Outline of presentation
• SRH Services
• HIV and AIDS Services
• Principles to Consider
• Potential Benefits
• Key links
• Challenges
• Critical considerations/questions
04/04/2013 2

3. Always look for opportunities around the Key Linkages
compartment
Sexual and HIV and
Reproductive Health AIDS
• Family Planning Key Linkages
• HIV and Family • Prevention: Condom
• Maternal and Infant
Planning Promotion and PMTCT
Care including
antenatal and • HIV and Reproductive • Diagnosis and
postnatal care Health Treatment: VCT, ARVs
• HIV and STI control and treatment of OI’s
• STI Diagnosis and
Treatment • PMTCT and Family • Care: Community
Planning, Antenatal home based care
• Post-Abortion Care
Care, Postnatal Care • Support for PLWHA
• Youth-Friendly
Services
• Counseling

4. Principles to consider while Linking SRH & HIV/AIDS
• Address structural determinants of HIV and SRH
(poverty, gender inequality, social marginalization, etc.)
• Focus on Human Rights and Gender
• Promote a national coordinated and coherent response
• Meaningfully involve PLWHA
• Foster community participation
• Reduce stigma and discrimination

5. Potential Benefits of Integration of SRH and HIV
• Access to services
– Improved access to and uptake of key HIV/AIDS and SRH
services including the community
– Better access by PLWHA to SRH services tailored to their
needs
– Reduced HIV/AIDS-related stigma and discrimination
– Improved coverage of underserved and marginalized
populations
– Greater support for dual protection
– Maximum use of limited resources.

6. Potential Benefits of Integration of SRH and HIV/AIDS
• Service Delivery
– Improved quality of care- one stop shop.
– Enhanced programme effectiveness and efficiency
– Decreased duplication of efforts and competition for
resources
– Better understanding and protection of individual rights
– Mutually reinforcing complementarities in legal and policy
frameworks including community intiatives.

7. Key Links: Priority Framework

8. Challenges to Integration of SRH and HIV/AIDS
• Overburdening existing services (initial phase)
• Increased workload for staff
• Increased costs initially
• Adapting services to attract men and young people
• Reaching the most vulnerable people
• Special training and ongoing support to staff
• Motivating donors to opt for integrated services
• Making the services available to the rural
communities (Hard to reach areas)

9. Critical Considerations/Questions to Integration
• Which service combinations are feasible?
• Which services are acceptable to clients and service providers?
• Which services can effectively increase access to one or both
without compromising the quality or safety of their delivery
• Does joint provision lead to synergistic impact to both the
individual client served and that of the community served?
• What to integrate at each level?
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