Effects of integration of hiy- aids care into reproductive health service on utilization of reproductive health services in Kenya
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Date
2014-10-01
Authors
Waweru, Lucy Anne Wanjiru
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Abstract
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.
Description
Masters of Public Health in the School of Health Sciences 90p. October, 2009