B. Dlamini, Nompumelelo Dlamini, Bonisile Nhalabatsi, M. Thwala-Tembe, S. Myeni, Lindiwe Malaza
{"title":"将艾滋病毒/艾滋病防治工作纳入生殖、孕产妇、新生儿和青少年健康平台:斯瓦蒂尼王国的经验","authors":"B. Dlamini, Nompumelelo Dlamini, Bonisile Nhalabatsi, M. Thwala-Tembe, S. Myeni, Lindiwe Malaza","doi":"10.4172/2155-6113.1000779","DOIUrl":null,"url":null,"abstract":"Background: The need to link HIV/AIDS and Sexual Reproductive Health (SRH) response is important due to the interconnectedness of HIV and SRH. Swaziland is implementing the Primary Health Care strategy which involves integration of a number of health services. However, in the early years of the HIV/AIDS epidemic, its programming and funding was prioritized in a vertical manner due to the scale and scare of the epidemic. Over the years, the country recognized that addressing HIV/AIDS and Sexual Reproductive Health and Rights (SRHR) services as totally separate entities is counterproductive in achieving targets for both HIV and SRHR. This assessment was aimed at documenting the extent of SRH and HIV integration in Swaziland. Methods: A mixed-methods approach was used to document the extent of SRHR and HIV integration. The quantitative approach included secondary data analysis using national data and reports on SRHR and HIV integration indicators between 2009 and 2016. The qualitative approach included in-depth desk review of documents as well as key informant interviews. Results: RMNCAH and HIV integration is supported by enabling policy environment across all levels. In 2016, 94% accessed HIV services and 95% of those testing HIV positive were initiated within the RMNCAH platform, while 92% of clients attending FP services eligible for HIV testing were tested and 75% of those tested HIV positive linked to care and treatment. An observed increasing trend of HIV testing within TB clinics from 66% in 2012 to 92% in 2016. A significant p-value (pr>Chi2≤0.0001) indicating HIV testing in STI clinics. Conclusion: The bi-directional integration of RMNCAH and HIV provides a concrete ground for reaching the ambitious UNAIDS targets (90-90-90). This integration is not only logic to the health delivery system; it’s also beneficial to the clients. Having one strategy, one coordinating structure and one M&E system may significantly lead to attainment of the UN-SDGs. Recommendations: Programmers should outline a minimum package of integration is paramount in scaling up HIV and RMNCAH integration. Continuous capacity building including supportive supervision and mentorship is needed to integrate health services. Citation: Dlamini BR, Dlamini N, Nhalabatsi B, Thwala-Tembe M, Myeni S, et al. (2018) The HIV/AIDS Response Succeeds When Integrated in the Reproductive Maternal Newborn Child and Adolescent Health Platform: The Experience of the Kingdom of Eswatini. 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Swaziland is implementing the Primary Health Care strategy which involves integration of a number of health services. However, in the early years of the HIV/AIDS epidemic, its programming and funding was prioritized in a vertical manner due to the scale and scare of the epidemic. Over the years, the country recognized that addressing HIV/AIDS and Sexual Reproductive Health and Rights (SRHR) services as totally separate entities is counterproductive in achieving targets for both HIV and SRHR. This assessment was aimed at documenting the extent of SRH and HIV integration in Swaziland. Methods: A mixed-methods approach was used to document the extent of SRHR and HIV integration. The quantitative approach included secondary data analysis using national data and reports on SRHR and HIV integration indicators between 2009 and 2016. The qualitative approach included in-depth desk review of documents as well as key informant interviews. Results: RMNCAH and HIV integration is supported by enabling policy environment across all levels. In 2016, 94% accessed HIV services and 95% of those testing HIV positive were initiated within the RMNCAH platform, while 92% of clients attending FP services eligible for HIV testing were tested and 75% of those tested HIV positive linked to care and treatment. An observed increasing trend of HIV testing within TB clinics from 66% in 2012 to 92% in 2016. A significant p-value (pr>Chi2≤0.0001) indicating HIV testing in STI clinics. Conclusion: The bi-directional integration of RMNCAH and HIV provides a concrete ground for reaching the ambitious UNAIDS targets (90-90-90). This integration is not only logic to the health delivery system; it’s also beneficial to the clients. Having one strategy, one coordinating structure and one M&E system may significantly lead to attainment of the UN-SDGs. Recommendations: Programmers should outline a minimum package of integration is paramount in scaling up HIV and RMNCAH integration. Continuous capacity building including supportive supervision and mentorship is needed to integrate health services. Citation: Dlamini BR, Dlamini N, Nhalabatsi B, Thwala-Tembe M, Myeni S, et al. (2018) The HIV/AIDS Response Succeeds When Integrated in the Reproductive Maternal Newborn Child and Adolescent Health Platform: The Experience of the Kingdom of Eswatini. 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引用次数: 0
摘要
背景:由于艾滋病毒和性健康与生殖健康相互关联,将艾滋病毒/艾滋病与性健康与生殖健康(SRH)应对措施联系起来的必要性非常重要。斯威士兰正在实施初级卫生保健战略,其中包括若干保健服务的整合。然而,在艾滋病毒/艾滋病流行的最初几年,由于该流行病的规模和可怕性,其方案编制和供资是以纵向方式优先考虑的。多年来,该国认识到,将艾滋病毒/艾滋病和性健康与生殖健康和权利服务作为完全独立的实体来处理,不利于实现艾滋病毒和性健康与生殖健康和权利的目标。该评估旨在记录斯威士兰性健康和生殖健康与艾滋病毒整合的程度。方法:采用混合方法来记录SRHR和HIV整合的程度。定量方法包括利用2009年至2016年期间的国家数据和关于SRHR和艾滋病毒整合指标的报告进行二次数据分析。定性方法包括对文件进行深入的案头审查以及对关键的线人进行面谈。结果:各级有利的政策环境支持RMNCAH和HIV整合。2016年,94%的人获得了艾滋病毒服务,95%的艾滋病毒检测呈阳性的人是在RMNCAH平台上开始的,而92%参加计划生育服务的客户有资格进行艾滋病毒检测,75%的艾滋病毒检测呈阳性的人接受了护理和治疗。观察到结核病诊所的艾滋病毒检测呈上升趋势,从2012年的66%上升到2016年的92%。显著的p值(pr>Chi2≤0.0001)表明在性病诊所进行HIV检测。结论:RMNCAH与HIV的双向整合为实现UNAIDS宏伟的目标(90-90-90)提供了坚实的基础。这种整合不仅符合卫生服务系统的逻辑;这对客户也是有利的。只有一个战略、一个协调结构和一个监测和评估系统,才能大大促进联合国可持续发展目标的实现。建议:程序员应该概述一个最小的集成包,这在扩展HIV和RMNCAH集成中是至关重要的。需要持续的能力建设,包括支持性监督和指导,以整合卫生服务。引用本文:Dlamini BR, Dlamini N, Nhalabatsi B, Thwala-Tembe M, Myeni S等。(2018)将艾滋病毒/艾滋病应对措施纳入生殖孕产妇新生儿和青少年健康平台:斯瓦蒂尼王国的经验。[J]艾滋病临床杂志,9:779。doi: 10.4172 / 2155 - 6113.1000779
The HIV/AIDS Response Succeeds When Integrated in the Reproductive Maternal Newborn Child and Adolescent Health Platform: The Experience of the Kingdom of Eswatini
Background: The need to link HIV/AIDS and Sexual Reproductive Health (SRH) response is important due to the interconnectedness of HIV and SRH. Swaziland is implementing the Primary Health Care strategy which involves integration of a number of health services. However, in the early years of the HIV/AIDS epidemic, its programming and funding was prioritized in a vertical manner due to the scale and scare of the epidemic. Over the years, the country recognized that addressing HIV/AIDS and Sexual Reproductive Health and Rights (SRHR) services as totally separate entities is counterproductive in achieving targets for both HIV and SRHR. This assessment was aimed at documenting the extent of SRH and HIV integration in Swaziland. Methods: A mixed-methods approach was used to document the extent of SRHR and HIV integration. The quantitative approach included secondary data analysis using national data and reports on SRHR and HIV integration indicators between 2009 and 2016. The qualitative approach included in-depth desk review of documents as well as key informant interviews. Results: RMNCAH and HIV integration is supported by enabling policy environment across all levels. In 2016, 94% accessed HIV services and 95% of those testing HIV positive were initiated within the RMNCAH platform, while 92% of clients attending FP services eligible for HIV testing were tested and 75% of those tested HIV positive linked to care and treatment. An observed increasing trend of HIV testing within TB clinics from 66% in 2012 to 92% in 2016. A significant p-value (pr>Chi2≤0.0001) indicating HIV testing in STI clinics. Conclusion: The bi-directional integration of RMNCAH and HIV provides a concrete ground for reaching the ambitious UNAIDS targets (90-90-90). This integration is not only logic to the health delivery system; it’s also beneficial to the clients. Having one strategy, one coordinating structure and one M&E system may significantly lead to attainment of the UN-SDGs. Recommendations: Programmers should outline a minimum package of integration is paramount in scaling up HIV and RMNCAH integration. Continuous capacity building including supportive supervision and mentorship is needed to integrate health services. Citation: Dlamini BR, Dlamini N, Nhalabatsi B, Thwala-Tembe M, Myeni S, et al. (2018) The HIV/AIDS Response Succeeds When Integrated in the Reproductive Maternal Newborn Child and Adolescent Health Platform: The Experience of the Kingdom of Eswatini. J AIDS Clin Res 9: 779. doi: 10.4172/2155-6113.1000779