Integration Of Family Planning, Reproductive Health, Antiretroviral Services Could Reduce HIV/AIDS Cases In Africa, Experts Say
"Integration of services into one-stop health care centers makes systems more supportive, especially for people living with HIV/AIDS," William Stone of the department of obstetrics and gynecology at the University of Aga Khan in Nairobi, Kenya, said. He said that most developing countries with high HIV/AIDS burdens focus on prevention of mother-to-child transmission programs but added that "it should be a whole package of preventing infections, unwanted pregnancies, postabortion care, PMTCT, treatment and care." Stone discussed the findings of two pilot projects in Ghana and Uganda. One study found that 39,000 HIV-positive births were prevented through PMTCT while 71,000 were prevented by family planning programs. "When you avoid unintended pregnancies, you avert more infections," he said.
According to Elly Mugumya, executive director of Reproductive Health Uganda, integration of services is long overdue. "Given that HIV is a sexuality issue and interlinked, we should have considered integration right from the beginning of our fight against the scourge," Mugumya said. "Let's not wait to give [antiretrovirals] and build orphanages. This can only be possible through integration" of family planning, reproductive health and HIV/AIDS treatment, Mugumya added.
Henry Kakande of ACQUIRE Project, a USAID-funded pilot program in Uganda, said that a "one-stop health care center would address" HIV/AIDS-related stigma and discrimination, as well as the lack of awareness about the disease. Providers also would be "empowered to handle such clients as they come because they are not comfortable opening up to different people and this undermines our efforts" to fight the disease and improve child and maternal health, he said.
According to the 2006 State of Uganda Population report, integration would increase efficiency and convenience for patients, as well as opportunities to promote reproductive health and HIV/AIDS awareness. However, the report found that shortages of health care workers might hinder the benefits of integration because demand could overload staff and diminish the quality of care. "Weak logistics systems are another issue, and each aspect requires strong supervision and referrals for management plus follow-up," the report said (Nabusoba/Emasu, New Vision/AllAfrica.com, 1/28).
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