What Works for Women and Girls

Pregnant women reported feeling out of place in the HIV clinic. (Bilonda and Njau,2008). (Abstract) (pregnancy, PMTCT, treatment, antenatal care, health facilities, Kenya)A 2008 study from Swaziland showed that integrating HAART into preexistingmaternal and child health (MCH) services increased the number of HIV-positive pregnantwomen initiating HAART (no numbers given). MCH services began offeringHAART for HIV-positive pregnant women and their families in February 2007. After 10months, 28% of pregnant women eligible for HAART initiated treatment in comparisonto only 5% initiating HAART during the 10 months previous to the integration. Over300 patients initiated HAART post-integration, 45% of which were pregnant women.Additionally, 25 family units enrolled in HAART services during this time demonstratingthe usefulness of integrated MCH/HAART services for women and their families(Mahdi et al., 2008). (Abstract) (health facilities, HAART, pregnancy, Swaziland)A 2004 to 2007 project in Ethiopia and Ukraine conducted by UNFPA andEngenderHealth that integrated HIV prevention interventions into maternal andchild health programs increased the numbers of women receiving HIV counselingand testing, and syphilis screening, as well as women’s intentions regarding HIV riskduring pregnancy. Interventions to support the introduction of integrated servicesincluded whole site training, minor upgrades to facility infrastructure and provisionof necessary supplies. Pre- and post-test training questionnaires were conducted with307 health providers and 64 women receiving services (Perchal et al., 2008). (Abstract)(HIV testing, counseling, health facilities, Ethiopia, Ukraine)A study in Rwanda found that provision of HIV care at VCT and PMTCT sites effectivelyenrolls more patients earlier in their illness and more effectively refers those eligiblefor HAART. In five health centers in 2007, 119 clients tested HIV-positive, of whom 118were referred to the nearest treatment site. Of the 118 patients referred, only 33% arrivedat the treatment site within three months. In the program that consisted of standardpre-antiretroviral therapy HIV care, 100 patients (74% female and 26% male) wereimmediately enrolled and staged during a three months period following their seropositiveHIV test. Of these, 26% were eligible for HAART and were referred to the nearesttreatment site where 91% of them were started on HAART (Ubarijoro et al., 2008).(Abstract) (health facilities, PMTCT, HAART, Rwanda)2. Promoting contraceptives and family planning counseling as part of routine HIV services(and vice versa) can increase condom use, contraceptive use, and dual method use, thusaverting unintended pregnancies among women living with HIV. [See also above and Chapter8. Meeting the Sexual and Reproductive Health Needs of Women Living with HIV]In Uganda, a project from 2006 to 2007 integrated family planning and HIV treatment,resulting in a three-fold increase in the number of HIV treatment patients accessingfamily planning. Evaluation data included 105 client exit interviews, 30 provider clientobservations, 37 self-administered provider questionnaires, six key informant inter-376 CHAPTER 13 STRUCTURING HEALTH SERVICES TO MEET WOMEN’S NEEDS