More than 100 people from Nakaseke District, Uganda have been benefiting from an initiative that has seen HIV and family planning services delivered in one setting.
The community outreach programme, run by people living with HIV (PHA) group Ani Yali Amanyi in collaboration with Kiwoko hospital, saw local people come to Kamuli primary school in Kikamulo sub county to receive a range of sexual and reproductive health services.
The activities conducted included immunisation of children, antenatal care, preventing mother to child transmission (PMTCT) services, HIV counselling and testing (HCT), family planning, medical male circumcision and guidance to youth on reproductive health.
Integration for Impact 2012
This is a great move towards integration ahead of the Integration for Impact conference, which takes place next month (12-14 September) in Nairobi, Kenya.
There is growing interest within the global health community in the potential public health impact of integrating different health services into a single delivery setting. Integrating programs for HIV, family planning and maternal, neonatal, and child health addresses patients’ multiple needs in one go and may enhance program effectiveness and efficiency.
Juliet Ankunda, a counsellor from Kiwoko hospital, said: “The HCT outreach focuses on sensitisation, counselling, HIV testing, PMTCT and family planning. And per outreach we target 100 to 150 persons in one place. But the homes are scattered and it is always difficult to get the target number during the rainy season when most people go out to their gardens. Even when there is a funeral in an area, most people will not come. The other challenge that we face is that most of our clients are women, there are a few men.”
Outreach worker Muloni Rebecca, who is living with HIV, says: “We go out and call people to go and check for their HIV status. We also expect that we shall get people with different HIV status after testing those that are HIV positive and those that are HIV negative. The good thing about such an outreach is that so many services are concentrated in one place.”
Namubiru Molly, who has been living with HIV for 16 years and is also an outreach worker, says: “I am happy that when we talk to people to respond to HCT activities they come and attend and receive the services from our outreach. We tell them about the challenges of PLHIV and how we have overcome stigma. Our duty is to direct them where to go and what to do, especially when a person finds out that they are HIV positive.”
Sserugo Matia, who mobilises people in communities for Ani Yali Amanyi PHA group, says: “I go to the villages and communities surrounding Kiwoko and take part in the registration of mothers and even the weighing of children. The last time we had such a community engagement activity we had over 100 people and I am happy that I am the one who mobilised them to come for this exercise.”
Mutebi Hassan, group leader for Ani Yali Amanyi, says: “The major challenge we face is transport and movement to transport for people who do [not have access to] mobilisation. We need bicycles and motorcycles for mobilisation.
“We cannot also do an outreach where there is no school or a community hall with facilities where health workers can store the vaccines. We need mobile shelters as of now. If we can get mobile tents it means we can be able to reach out places without schools or churches, and this means reaching out to more people.”
A statement on the Integration for Impact website reads: “Although HIV/AIDS prevention and care programs are expanding in sub-Saharan Africa, in most settings these services are offered in isolation from MNCH services and FP services. Program managers and policymakers have begun to recognise the missed opportunities and inefficiencies created by these vertical ‘siloed’ approaches.
“Experiences in some sub-Saharan African settings suggest that integrating reproductive health and HIV services may improve access to contraception for HIV-infected individuals, increase uptake of prevention of mother-to-child transmission services and cervical cancer screening, and lead to earlier initiation and sustained use of anti-retroviral therapy.”
For news during the Integration for Impact conference visit the KC website, where a team of KCs will be reporting.
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