SRH and HIV/AIDS Linkages at Policies, Programmes and Service ...
SRH and HIV/AIDS Linkages at Policies, Programmes and Service ...
SRH and HIV/AIDS Linkages at Policies, Programmes and Service ...
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BANGLADESHCAMBODIANEPALPHILIPPINESSERVICE DELIVERYOverall, the integr<strong>at</strong>ed <strong>and</strong> linked <strong>SRH</strong><strong>and</strong> <strong>HIV</strong> services have been offered <strong>at</strong>selected referral hospitals <strong>and</strong> healthcentres. The <strong>SRH</strong> services includingANC, FP, m<strong>at</strong>ernal <strong>and</strong> child health,STI <strong>and</strong> other <strong>SRH</strong> services areoffered <strong>at</strong> health centres <strong>and</strong> integr<strong>at</strong>edor linked to <strong>HIV</strong> services established inoper<strong>at</strong>ional districts.Based on the Guide for Implement<strong>at</strong>ionof Positive Prevention among PL<strong>HIV</strong>,the positive prevention message <strong>and</strong>family planning service can be offered <strong>at</strong>selected health facilities where PL<strong>HIV</strong>access care <strong>and</strong> tre<strong>at</strong>ment.According to the draft of str<strong>at</strong>egicplan 2011-2015, <strong>HIV</strong> continuum ofcare <strong>and</strong> support components havebeen revised, with a restructuredcollabor<strong>at</strong>ion diagram th<strong>at</strong> indic<strong>at</strong>es thelinking of comprehensive health careservices between all levels in oper<strong>at</strong>ionaldistricts. In the draft of the revisedstr<strong>at</strong>egic plan health service delivery(HSD) is one of the <strong>HIV</strong> care <strong>and</strong>tre<strong>at</strong>ment components th<strong>at</strong> includes allhealth services <strong>at</strong> MPA <strong>and</strong> CPA levelsavailable to PL<strong>HIV</strong>. <strong>HIV</strong> testing (entrypoint to care) <strong>and</strong> OI/ART services areessential parts of the HSD.The HSD for PL<strong>HIV</strong> has been recentlystrengthened through the linkedresponse approach with an integr<strong>at</strong>ionof the 3 I’s str<strong>at</strong>egy for TB-<strong>HIV</strong> <strong>and</strong> apackage of positive prevention activitiesfor PL<strong>HIV</strong> th<strong>at</strong> includes 1) advice<strong>and</strong> counselling on condom use; 2)counselling on ART adherence; 3)advice on birth spacing/condom <strong>and</strong>safe abortion services; 4) TB infectioncontrol services; 5) STI prevention <strong>and</strong>case management, <strong>and</strong> the provision offamily planning services.Constraints of the integr<strong>at</strong>ed/linked<strong>SRH</strong> <strong>and</strong> <strong>HIV</strong> services th<strong>at</strong> may arisewithin the next five years could be:Shortage of equipment for offeringintegr<strong>at</strong>ed servicesShortage of space for offeringpriv<strong>at</strong>e <strong>and</strong> confidential servicesShortage of staff timeShortage of staff trainingInappropri<strong>at</strong>e/insufficient staffsupervisionLow staff motiv<strong>at</strong>ionLinking <strong>SRH</strong> <strong>and</strong> <strong>HIV</strong> services couldimpact on the increased cost of healthservices, cost for clients, workload ofhealth care providers, space <strong>and</strong> privacy,<strong>and</strong> the need for equipment, supplies<strong>and</strong> drugs.ConclusionThe results indic<strong>at</strong>e th<strong>at</strong> there is limitedspecific policies or str<strong>at</strong>egies for anintegr<strong>at</strong>ed <strong>HIV</strong> <strong>and</strong> <strong>SRH</strong> programme.Currently, integr<strong>at</strong>ed/linked <strong>HIV</strong><strong>and</strong> <strong>SRH</strong> services have been deliveredbased on separ<strong>at</strong>e policies, str<strong>at</strong>egies,guidelines, <strong>and</strong> SoPs. However, somelevel of integr<strong>at</strong>ion/linkage between<strong>SRH</strong> <strong>and</strong> <strong>HIV</strong> programmes has beeniniti<strong>at</strong>ed <strong>at</strong> the service delivery level,strengthened through the introductionof the linked response approach <strong>and</strong>positive prevention for PL<strong>HIV</strong>.62
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