Perspectives of healthcare providers around providing family planning services to women living with HIV attending six HIV treatment clinics in Lusaka, Zambia.

IF 1.2 4区 医学 Q4 HEALTH POLICY & SERVICES Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv Pub Date : 2024-10-20 DOI:10.1080/09540121.2024.2414077
Amy Medley, Tiffiany Aholou, Sherri Pals, Tiffany G Harris, Brenda Senyana, Mollie Braaten, Prisca Kasonde, Tina Chisenga, Annie Mwila, Keith Mweebo, Fatima Tsiouris
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Abstract

ABSTRACTWhile international guidelines recommend integration of family planning (FP) and HIV services, limited research has been done to explore how healthcare providers perceive the feasibility and utility of integrated services. To address this gap, we administered a standardized questionnaire to 85 providers from 6 HIV clinics in Lusaka, Zambia, before (April-May 2018) and after (May-June 2019) implementing an enhanced model of FP/HIV service integration. We tested for differences in FP knowledge, attitudes and practices between the two time periods with tests appropriate for paired observations. The proportion of providers self-reporting direct provision of contraceptives increased significantly for several methods including oral contraceptives (14% vs. 26%, p = 0.03), injectables (9% vs. 25%, p < 0.001), implants (2% vs. 13%, p = 0.007) and intra-uterine devices (2% vs. 13%, p = 0.007). In-depth interviews were also conducted post-integration with 109 providers to solicit their feedback on the benefits and challenges of offering integrated services. While providers were highly supportive of integrated services, they identified several challenges including widespread belief in FP myths among female clients, the need to consult a male partner prior to starting FP, lack of trained staff and space, and frequent stockouts of contraceptives and equipment. Addressing these challenges will be critical in designing future services.

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在赞比亚卢萨卡的六家艾滋病治疗诊所就诊的女性艾滋病感染者对计划生育服务的看法。
摘要尽管国际指南建议整合计划生育(FP)和艾滋病服务,但对医疗服务提供者如何看待整合服务的可行性和实用性的研究却十分有限。为了填补这一空白,我们在赞比亚卢萨卡的 6 家 HIV 诊所对 85 名医疗服务提供者进行了标准化问卷调查,调查时间分别为实施 FP/HIV 服务整合增强模式之前(2018 年 4 月至 5 月)和之后(2019 年 5 月至 6 月)。我们采用适合配对观察的检验方法检验了两个时间段内计划生育知识、态度和实践的差异。服务提供者自我报告直接提供避孕药具的比例在几种方法上有显著增加,包括口服避孕药(14% 对 26%,p = 0.03)、注射剂(9% 对 25%,p = 0.007)和宫内节育器(2% 对 13%,p = 0.007)。整合后还对 109 名医疗服务提供者进行了深入访谈,以征求他们对提供整合服务的益处和挑战的反馈意见。虽然服务提供者非常支持综合服务,但他们也指出了一些挑战,包括女性客户普遍相信 FP 神话,在开始使用 FP 之前需要咨询男性伴侣,缺乏训练有素的工作人员和空间,以及避孕药具和设备经常缺货。应对这些挑战对于设计未来的服务至关重要。
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来源期刊
CiteScore
3.50
自引率
0.00%
发文量
172
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