Effects of integration of hiy- aids care into reproductive health service on utilization of reproductive health services in Kenya
Waweru, Lucy Anne Wanjiru
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In most settings throughout the world, reproductive health and HIV and AIDS services are offered with little or no integration. Reproductive health services primarily target married women of reproductive health age bracket while HIV and AIDS services target individuals at high risk of HIV and AIDS infection. However the potential benefits of integrating these services are increasingly apparent as ever more women of reproductive age are becoming infected with HIY and AIDS or are at risk of getting infected. In addition to the potential of reproductive health providers reaching women who account for nearly half of all adults living with HIV and AIDS with HIV prevention, information and treatment. This has resulted to many types of integration being explored but their effects on reproductive health services have not been rigorously evaluated and are largely unknown. Therefore the study sought to expose the effects of integration of HIV and AIDS care into reproductive health services on the utilization of reproductive health services in Kenya. The study was carried out at Nairobi-west and Thika family care medical clinic which were conveniently sampled. A longitudinal study design was employed where records of clients utilizing reproductive health services from the study sites were reviewed. Retrospectively and prospectively for six months from the onset of integration. The results of the retrospective review generated the baseline data while the prospective review generated results that would be compared against the baseline data to assess whether the integration had affected the utilization of the reproductive health services. In addition to how the integration had affected the utilization of the reproductive health services. To build on the data generated from the review of records, primary data was collected from a sample of a hundred and ninety four clients and service providers from the study sites. The clients were sampled on availability while all service providers were considered. Interview schedules and self-administered questionnaires were used to collect the data from clients. Key informant interviews were used to collect the views of service providers regarding integration. Data analysis was done using SPSS software. Descriptive statistics were done to determine frequencies, means and percentages. A paired sample t-test was used to determine whether there was a significant difference.in uptake of reproductive health services before and after integration. Chi-square was used to establish associations of various variables. Data from key informant was summarized and discussed under various themes. Data was presented in graphs and tables. Integration had improved the access of services because of the increments in the total number of clients that were registered in general and in the respective study sites after integration. Moreover it had improved the quality of services and it was widely accepted among the clients and service providers. While most of the clients were aware of existence of HIV/AIDS services, only a minority could specify the nature of services available at the facilities. Awareness was mainly acquired through pamphlets and brochures. In addition the utilization of HIV/AIDS services integrated into reproductive health services was low. The fmdings of the study will be used by the players in the health sector in the formulation of policies, conceptual and legislative frame works in support of integration.