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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Integrating family planning services into HIV care and treatment clinics in Tanzania: Evaluation of a facilitated referral model
Health Policy and Planning, Volume 29, No. 5, Year 2014
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Description
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. © 2013 The Author.
Authors & Co-Authors
Baumgartner, Joy Noel
United States, Durham
Fhi 360
Green, Mackenzie Kenzie S.
United States, Durham
Fhi 360
Weaver, Mark A.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Mpangile, Gottlieb S.
Tanzania, Dar es Salaam
Tunajali Ii
Kohi, Thecla W.
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Mujaya, Stella N.
Tanzania, Dar es Salaam
Futures Group International
Lasway, Christine
United States, Durham
Fhi 360
Statistics
Citations: 38
Authors: 7
Affiliations: 5
Identifiers
Doi:
10.1093/heapol/czt043
e-ISSN:
14602237
Research Areas
Infectious Diseases
Sexual And Reproductive Health
Study Design
Randomised Control Trial
Cross Sectional Study
Quasi Experimental Study
Study Approach
Quantitative
Study Locations
Tanzania
Participants Gender
Female