Assessing the Benefits of Integrated HIV and Reproductive Health Services in Kenya, Malawi, and Swaziland: The Integra Initiative
The Council is collaborating with the London School of Hygiene & Tropical Medicine and IPPF to gather evidence and determine the benefits and costs of using different models for delivering integrated HIV and RH services to reduce HIV infection (and associated stigma) and unintended pregnancy.
The primary goal of this five-year research project is to gather evidence to determine the costs and benefits of models used to deliver integrated HIV and sexual and reproductive health (SRH) services in high- and medium-high-HIV-prevalence settings for reducing HIV (and associated stigma) and unintended pregnancies.
The project has four main objectives: (1) to determine the benefits of different integrated models to increase the reach, uptake, and quality of selected SRH and HIV services; (2) to determine the impact of services on changes in HIV risk behaviors, related stigma, and unintended pregnancies; (3) to establish the efficiency of using different operational models to deliver integrated services; and (4) to increase utilization of research findings by policy and program decisionmakers through involvement of and dissemination of research results to key stakeholders.
Three different models for delivering HIV services in existing SRH facilities are currently being evaluated in Kenya, Malawi, and Swaziland in both government and International Planned Parethood Federation (IPPF) facilities. The three models are: (1) integrating HIV counseling and testing and antiretroviral therapy (ART) into family planning services (Kenya only); (2) strengthening HIV counseling and testing and ART services (including family planning) in postnatal consultations (Kenya and Swaziland); and (3) integrating HIV counseling and testing and ART into family planning services for youth (Swaziland and Malawi). The project is assessing the benefits and costs of these models using a combination of routine service statistics and process analysis; clinic- and cohort-based quantitative and qualitative behavioral research; and community surveys and economic analysis.
The integration of HIV prevention counseling, including counseling and testing for HIV, into existing family planning services and the links with ART services either on-site or through referral will be evaluated in Kenya. In Kenya and Swaziland the project also will explore the benefits associated with strengthening HIV and family planning services among women attending antenatal and postnatal care services. The provision of integrated HIV and SRH services with a focus on young people will be evaluated in youth friendly-clinics in IPPF member associations in Malawi and Swaziland.
The first round of data collection has been finalized. Preliminary findings were presented at the XVIII International AIDS Conference in Vienna in July 2010.
Integra Initiative newsletter, March 2012 (PDF)
Publication date: 2012
Optimising the cost and delivery of HIV counselling and testing services in Kenya and Swaziland (abstract) (HTML)
Obure,Carol Dayo; Vassall,Anna; Michaels,Christine; Terris-Prestholt,Fern; Mayhew,Susannah H.; Stackpool-Moore,Lucy; Warren,Charlotte; The Integra Research Team; Watts,Charlotte
Sexually Transmitted Infections 88(7): 498-503
Publication date: 2012
Duration: 1/2008 - 12/2012
Population Council researchers:
Family Health Options Kenya
Family Life Association of Swaziland
Family Planning Association of Malawi
International Planned Parenthood Federation
Kenya Ministry of Health
London School of Hygiene & Tropical Medicine
Swaziland Ministry of Health
Bill & Melinda Gates Foundation