Family planning is a powerful and cost-effective HIV prevention approach, enabling HIV-infected women to prevent unintended pregnancies and thus transmission of HIV from mother to child. But is it feasible to offer family planning services to women accessing voluntary counseling and testing (VCT) services without detracting from those VCT services?
Research in Kenya by Family Health International and partners indicates it is. An intervention measuring the effect of integrating family planning services within 14 VCT centers there improved family planning service provision without compromising VCT quality of care.
In the study, an estimated 8 percent of VCT clients were HIV-positive and at risk of unintended pregnancy (and thus possible HIV transmission from mother to child). Overall, nearly a third of VCT clients were found to be at risk of unintended pregnancy.
Thus, as service integration continues in Kenya, researchers say advocacy efforts should emphasize that many VCT clients — both HIV-infected and
-uninfected — are at risk of unintended pregnancy. To determine whether new knowledge or awareness of family planning's benefits actually increases contraceptive uptake, such uptake should be monitored, along with the quality of VCT services.
Read or download the full study report.
|
The Intervention . . .
- Development of a training curriculum approved by the Kenyan government.
- Advocacy and sensitization: By March 2006, over 450 people, including counselors, supervisors, and provincial and district health managers, had attended meetings raising awareness of the feasibility of adding family planning to VCT services and of contraception's benefits for VCT clients.
- Training of VCT providers: By May 2006, 38 trainers and 132 providers from 68 VCT centers had received family planning/VCT service integration training.
photo credit: Heidi Reynolds/FHI |
. . . And its Effects on Family Planning Provision
- Discussion of any family planning method increased 17 percent from baseline to follow-up.
- Compared with untrained providers, trained providers were more than twice as likely to discuss family planning use and desire for children, more than three times as likely to discuss contraceptive pills and injectables, and more than eight times as likely to discuss other forms of contraception.
- Almost all supervisors and providers, and more than half of clients, said the introduction of family planning either improved or did not negatively affect VCT quality.
- The number of clients leaving VCT centers with a contraceptive method did not increase significantly, and even at follow-up, 40 percent of clients said they had not received any family planning information.
|
