More Women Access Family Planning Services When They are Integrated with HIV and Other Services

The Kitwe Teaching Hospital in Zambia services a large number of HIV-positive people who are on antiretroviral therapy (ART). Recently, the hospital analyzed its patient data and concluded that although most of its female patients were of reproductive age, they were not receiving adequate family planning/reproductive health (FP/RH) services. This was, at least in part, because they could not access these services while they were at the hospital for other reasons—they had to make separate appointments. FP services were only available in the gynecological and obstetrical departments and not at the ART clinic.

For Marvis, a 27-year-old mother of two, the cost and inconvenience of multiple appointments was aggravated by the fact that she had to reveal her HIV-positive status to multiple providers, compromising her privacy.

In an effort to improve convenience and client comfort, hospital management and other staff expanded FP to all hospital service entry points, increasing the number of FP service points from one to five. USAID Supporting an AIDS-Free Era (SAFE) provided standard operating manuals and integrated FP registers for all five FP services points. USAID SAFE also helped the hospital integrate FP/RH into HIV and other services so that patients could get care for multiple health needs at the same time.

USAID SAFE supported long-acting reversible contraception training for three hospital staff members, and extensive onsite mentorship for three other providers on screening FP patients to see if they needed additional services, including breast and cervical cancer screening and HIV and sexually transmitted infection testing.

Marvis appreciates spending less time in the health facility as a result of integrated service provision. She’s also seen an increase in support from her husband, who has agreed to practice dual protection (two methods of FP used at the same time) after his participation in FP group health talks. Kamanga, who has been an ART patient at Kitwe since 2006, is another person who has benefitted from service integration. Now, in addition to ART, he receives FP counselling services and the FP method of his choice.

USAID SAFE directly supports the Government of Zambia’s (GRZ) long-term vision of becoming a nation free from the threat of HIV and AIDS by 2030. The program works to reduce HIV mortality, morbidity, and transmission, while improving nutrition outcomes and family planning integration in three provinces: Central, Copperbelt, and North-Western. The USAID-funded initiative is implemented by John Snow, Inc., in collaboration with Abt Associates, mothers2mothers, and the Catholic Medical Mission Board.