Integrated services

Integrating reproductive health, family planning and STI/HIV prevention and treatment services is critical for achieving universal access. Integration requires that health care workers can provide an appropriate comprehensive package of services under one roof, and refer patients to other services if required. Linking STI/HIV with SRH services improves access to HIV/STI services for women who might otherwise not visit them because of issues of stigma. It also improves access to reproductive health services for people living with HIV and AIDS whose reproductive health needs and rights are often overlooked.

Integrating services into mainstream existing primary health care facilities makes them more accessible for non-traditional users of family planning services such as men and adolescents. In Tanzania, linking of youth friendly SRH services with public health facilities meant that adolescents were able to use services and get information without fear of being stigmatised by adults. In Bangladesh, integration of reproductive health services for men in family welfare centres increased their access to and acceptance of services to address their specific SRH needs. This initiative also led to a substantial rise in the number of women using services.

Integrating SRH services into public facilities provides greater potential for scaling up services and maintaining them on a long-term basis as networks are already in place across countries. Successful integration necessitates political commitment towards providing a comprehensive package of primary health care services and technical and financial support towards achieving this. Many attempts to integrate SRH services have encountered problems at the programme and service level. These include difficulties in: allocating and coordinating responsibilities; ensuring effective communication between staff in programmes; training staff with appropriate skills to meet a broader range of demands; strengthening referral services.

Strengthening linkages for sexual and reproductive health, HIV and AIDS: progress, barriers and opportunities for scaling up: This review, produced by the DFID Health Resource Centre, explores the policy, financing and institutional factors that enable or constrain the integration of sexual and reproductive health and rights programmes with policy programmes for HIV prevention and AIDS treatment and care.