Integrating VCT into Family Planning in South Africa

Study compares costs of integration models.

Family Health Research: 2007, Vol. 1, Issue 1

The Models Full integration: Providers trained to conduct pre- and post-test counseling and rapid HIV testing on site. Partial integration: Providers trained to offer pretest counseling and refer clients for HIV testing. Separate services: Family planning and VCT services remained separate.

A recent assessment of the costs of two models for integrating HIV voluntary counseling and testing (VCT) into family planning clinics in South Africa's Northwest Province found that either model was likely to be less expensive than creating and staffing a stand-alone VCT center.

The cost assessment by Family Health International, which sought to identify ways to increase family planning clients' access to VCT, was part of a FRONTIERS (Population Council/South Africa) study implemented by the South African Ministry of Health. In that study, 18 clinics were assigned to one of the following models: full integration, partial integration, or the standard model of separate family planning and HIV services.

The study ultimately found that the two integration models were feasible, acceptable, and effective without compromising the quality of family planning services.¹  Based on the study results, an evaluation of a model for increasing VCT uptake, uptake of dual protection against unintended pregnancy and HIV infection, and improving quality of family planning services is under way in South Africa. A similar study is being conducted by the Ministry of Health in Kenya and will be evaluated by FRONTIERS.

For the cost assessment, both the start-up cost of training family planning providers and annual cost of delivering integrated services were assessed. The findings indicate that, compared to the cost of setting up additional free-standing VCT centers:

• Fully integrating services with family planning service delivery points could be more efficient if family planning providers have time to provide VCT to clients.
• Partial integration could be more efficient if family planning providers are too busy to offer VCT to clients and nearby testing centers are underutilized.

Reference

1. Mullick S, Askew I, Maluka T, et al. Integrating counseling and testing into family planning services: What happens to the existing quality of family planning when HIV services are integrated in South Africa? Linking Reproductive Health and Family Planning with HIV/AIDS Programs in Africa. Addis Ababa, Ethiopia, October 9-10, 2006.