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Integrating family planning services into HIV care and treatment clinics in Tanzania: evaluation of a facilitated referral model.
Baumgartner, Joy Noel; Green, Mackenzie; Weaver, Mark A; Mpangile, Gottlieb; Kohi, Thecla W; Mujaya, Stella N; Lasway, Christine.
Affiliation
  • Baumgartner JN; FHI 360, Washington, DC 20009, USA, FHI 360, Research Triangle Park, NC, USA, University of North Carolina at Chapel Hill,, Chapel Hill, NC, USA, TUNAJALI II, Deloitte, Dar es Salaam, Tanzania, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania and Futures Group, Dar es Sala
  • Green M; FHI 360, Washington, DC 20009, USA, FHI 360, Research Triangle Park, NC, USA, University of North Carolina at Chapel Hill,, Chapel Hill, NC, USA, TUNAJALI II, Deloitte, Dar es Salaam, Tanzania, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania and Futures Group, Dar es Sala
  • Weaver MA; FHI 360, Washington, DC 20009, USA, FHI 360, Research Triangle Park, NC, USA, University of North Carolina at Chapel Hill,, Chapel Hill, NC, USA, TUNAJALI II, Deloitte, Dar es Salaam, Tanzania, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania and Futures Group, Dar es Sala
  • Mpangile G; FHI 360, Washington, DC 20009, USA, FHI 360, Research Triangle Park, NC, USA, University of North Carolina at Chapel Hill,, Chapel Hill, NC, USA, TUNAJALI II, Deloitte, Dar es Salaam, Tanzania, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania and Futures Group, Dar es Sala
  • Kohi TW; FHI 360, Washington, DC 20009, USA, FHI 360, Research Triangle Park, NC, USA, University of North Carolina at Chapel Hill,, Chapel Hill, NC, USA, TUNAJALI II, Deloitte, Dar es Salaam, Tanzania, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania and Futures Group, Dar es Sala
  • Mujaya SN; FHI 360, Washington, DC 20009, USA, FHI 360, Research Triangle Park, NC, USA, University of North Carolina at Chapel Hill,, Chapel Hill, NC, USA, TUNAJALI II, Deloitte, Dar es Salaam, Tanzania, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania and Futures Group, Dar es Sala
  • Lasway C; FHI 360, Washington, DC 20009, USA, FHI 360, Research Triangle Park, NC, USA, University of North Carolina at Chapel Hill,, Chapel Hill, NC, USA, TUNAJALI II, Deloitte, Dar es Salaam, Tanzania, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania and Futures Group, Dar es Sala
Health Policy Plan ; 29(5): 570-9, 2014 Aug.
Article in En | MEDLINE | ID: mdl-23894070
ABSTRACT

BACKGROUND:

Many clients of HIV care and treatment services have unmet contraceptive needs. Integrating family planning (FP) services into HIV services is an increasingly utilized strategy for meeting those unmet needs. However, numerous models for services integration are potentially applicable for clients with diverse health needs. This study developed and tested a 'facilitated referral' model for integrating FP into HIV care and treatment in Tanzania with the primary outcome being a reduction in unmet need for contraception among female clients.

METHODS:

The facilitated referral model included seven distinct steps for service providers. A quasi-experimental, pre- and post-test, repeated cross-sectional study was conducted to evaluate the impact of the model. Female clients at 12 HIV care and treatment clinics (CTCs) were interviewed pre- and post-intervention and CTC providers were interviewed post-intervention.

RESULTS:

A total of 323 CTC clients were interviewed pre-intervention and 299 were interviewed post-intervention. Among all clients, the adjusted decrease in proportion with unmet need (3%) was not significant (P = 0.103) but among only sexually active clients, the adjusted decrease (8%) approached significance (P = 0.052). Furthermore, the proportion of sexually active clients using a contraceptive method post-intervention increased by an estimated 12% (P = 0.013). Dual method use increased by 16% (P = 0.004). Increases were observed for all seven steps of the model from pre- to post-intervention. All providers (n = 45) stated that FP integration was a good addition although there were implementation challenges.

CONCLUSION:

This study demonstrated that the facilitated referral model is a feasible strategy for integrating FP into HIV care and treatment services. The findings show that this model resulted in increased contraceptive use among HIV-positive female clients. By highlighting the distinct steps necessary for facilitated referrals, this study can help inform both programmes and future research efforts in services integration.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: HIV Infections / Contraception Behavior / Family Planning Services Type of study: Evaluation_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Limits: Adolescent / Adult / Female / Humans / Middle aged Country/Region as subject: Africa Language: En Journal: Health Policy Plan Journal subject: PESQUISA EM SERVICOS DE SAUDE / SAUDE PUBLICA Year: 2014 Document type: Article
Fulltext
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: HIV Infections / Contraception Behavior / Family Planning Services Type of study: Evaluation_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Limits: Adolescent / Adult / Female / Humans / Middle aged Country/Region as subject: Africa Language: En Journal: Health Policy Plan Journal subject: PESQUISA EM SERVICOS DE SAUDE / SAUDE PUBLICA Year: 2014 Document type: Article