title: Perceptions and Experiences of Integrated Service Delivery Among Women Living with HIV Attending Reproductive Health Services in Kenya: A Mixed Methods Study.
abstract: This is one of the few studies that explores preferences of and experiences with integrated sexual and reproductive health (SRH)-HIV care among users of mainstream family planning and postnatal care services who are women living with HIV (WLWH). This paper reports on the quantitative data from 179 clients attending public sector clinics and from 30 qualitative in-depth interviews with WLHIV in Kenya. Quantitative data show that integration is happening for the vast majority of these clients at their last HIV visit. However, qualitative data show that very often the care received by WLWH is fragmented as providers do not offer multiple same-day appointments for FP and ARV refills. Our study has shown factors that could either prevent or enable receipt of integrated SRH and HIV care for WLWH. To address these factors, management systems need to be able to support providers to make flexible decisions and facilitate better coordination and communication across clinics within facilities.
authors.affiliation: Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK. manuela.colombini@lshtm.ac.uk.
authors.forename: M
authors.initials: M
authors.lastname: Colombini
authors.affiliation: Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: S H
authors.initials: SH
authors.lastname: Mayhew
authors.affiliation: Health Systems Strengthening & Primary Health Care, Centre for Infectious Disease Research Zambia (CIDRZ), Lusaka, Zambia.
authors.forename: R
authors.initials: R
authors.lastname: Mutemwa
authors.affiliation: Population Council, Nairobi, Kenya.
authors.forename: J
authors.initials: J
authors.lastname: Kivunaga
authors.affiliation: Reproductive Health Program, Population Council, Nairobi, Kenya.
authors.forename: C
authors.initials: C
authors.lastname: Ndwiga
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D005193:Family Planning Services / Q000458:organization & administration*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D007630:Kenya; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000523:psychology; D010465:Perception; D036301:Qualitative Research; D034121:Reproductive Health Services / Q000458:organization & administration*; D012725:Sexual Behavior; D057545:Social Stigma
chemical_list: D019380:Anti-HIV Agents
keywords: Clients’ experiences; HIV; Integration; Kenya; Perceptions