Sexual and reproductive health activities in HIV programmes: can we monitor progress?
BACKGROUND
Resource allocation and integration of services have been of interest recently to achieve health-related Millennium Development Goals. This paper analyses the extent to which countries receiving funding in HIV were able to invest in activities in the area of sexual and reproductive health (SRH).


METHODS
The authors screened the Global Fund grants data with an aggregate investment of US$16 billion in 140 countries to identify indicators revealing typical SRH services. The analysis focused on the 'Top Ten' internationally agreed indicators and used international guidelines and frameworks to define services for SRH and opportunities for 'linkage' between HIV and SRH services.


RESULTS
As of December 2008, 238 of all HIV grants (n = 252) from 133 countries included 1620 service delivery indicators related to SRH. The budgets amounted to US$9.1 billion with US$5.9 billion committed and US$4 billion disbursed. Services included (1) prevention of mother to child transmission for 445,000 HIV-positive pregnant women, (2) 5.7 million care and support services, (3) 1.2 billion condoms delivered, (4) 4.4 million episodes of sexually transmitted infections treated, (5) 61 million counselling and testing encounters, and (6) 11.6 million behavioural change communication (BCC) outreach services for people at high risk and 64.5 million BCC activities for the general population, including youth. Information on the linkage and integration of SRH-HIV services was limited.


CONCLUSIONS
Around 94% of HIV programmes supported SRH-related activities. However, there is a need to systematically capture data on SRH-HIV service integration to understand the benefits of linking these services.
Komatsu
Ryuichi
R
The Global Fund to Fight AIDS, Tuberculosis and Malaria, Chemin de Blandonnet 8, 1214 Vernier, Geneva, Switzerland. ryuichi.komatsu@theglobalfund.org
Lee
Donna
D
Lusti-Narasimhan
Manjula
M
Martineau
Tim
T
Vinh-Thomas
Elmar
E
Beer
Daniel Low
DL
Atun
Rifat
R
D019985:Benchmarking; D002017:Budgets / Q000706:statistics & numerical data; D003299:Cooperative Behavior; D003376:Counseling / Q000191:economics / Q000706:statistics & numerical data; D003659:Decision Making, Organizational; D019033:Delivery of Health Care, Integrated / Q000592:standards; D005260:Female; D005381:Financing, Organized / Q000331:legislation & jurisprudence / Q000379:methods / Q000458:organization & administration; D014943:Global Health; D006040:Goals; D015658:HIV Infections / Q000175:diagnosis / Q000517:prevention & control* / Q000628:therapy; D006679:HIV Seropositivity / Q000175:diagnosis / Q000191:economics; D006293:Health Promotion / Q000191:economics / Q000379:methods; D006297:Health Services Accessibility / Q000191:economics / Q000592:standards; D006305:Health Status Indicators; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D007449:Investments; D020380:Needs Assessment; D011247:Pregnancy; D011314:Preventive Health Services / Q000191:economics / Q000379:methods* / Q000592:standards; D015397:Program Evaluation / Q000191:economics*; D060728:Reproductive Health / Q000191:economics* / Q000592:standards; D040242:Risk Reduction Behavior; D012749:Sexually Transmitted Diseases / Q000517:prevention & control / Q000628:therapy