title: Challenges encountered in providing integrated HIV, antenatal and postnatal care services: a case study of Katakwi and Mubende districts in Uganda.
abstract: BACKGROUND
  Integration of sexual and reproductive health (SRH), HIV/AIDS and maternal health (MH) services is a critical strategy to confront the HIV/AIDS epidemic, high maternal mortality and the unmet need for contraception. In 2011 the AIDS Information Centre (AIC) in partnership with the Ministry of Health implemented SRH, HIV/AIDS and MH integration services in the districts of Katakwi and Mubende in Uganda. This paper documents challenges encountered in providing these integrated services in the two districts.
  
  
  METHODS
  This was a cross-sectional qualitative study conducted in Mubende and Katakwi districts in Uganda. Data were collected using 10 focus group discussions with 89 women attending ANC and postnatal care and 21 key informant interviews with district managers and health workers who were involved in the integrated service delivery. Content thematic approach was used for data analysis.
  
  
  RESULTS
  The study findings indicate that various challenges were encountered in integrating HIV, ANC and PNC services. Major challenges included inadequate staff, gaps in knowledge of service providers especially with regard to provision of long-term family planning, limited space, shortage of critical supplies such as HIV test kits, drugs and gloves.
  
  
  CONCLUSIONS
  These findings indicate that the delivery of integrated HIV, SRH and MH services is hampered greatly by health system challenges and depict the need for additional staffing in health facilities, capacity building of health workers and health managers as well as ensuring sufficient supplies to health facilities for smooth implementation of integrated SRH, HIV and MH services.
authors.affiliation: MakSPH-CDC Fellowship Program, Makerere University College of Health Sciences, School of Public Health, P.O. Box 7072, Kampala, Uganda. tashaahumuza@gmail.com.
authors.forename: Sharon Eva
authors.initials: SE
authors.lastname: Ahumuza
authors.affiliation: Department of Peadiatrics and Child Health, College of Health Sciences, School of Medicine, Makerere University, P.O. Box 7072, Kampala, Uganda.
authors.forename: Joseph
authors.initials: J
authors.lastname: Rujumba
authors.affiliation: AIDS Information Center, Plot 1321 Musaja Alumbwa, Mengo-Kisenyi, Kampala, Uganda.
authors.forename: Abdallah
authors.initials: A
authors.lastname: Nkoyooyo
authors.affiliation: AIDS Information Center, Plot 1321 Musaja Alumbwa, Mengo-Kisenyi, Kampala, Uganda.
authors.forename: Raymond
authors.initials: R
authors.lastname: Byaruhanga
authors.affiliation: Department of Disease Control and Environmental Health, Makerere University College of Health Sciences, School of Public Health, P.O. Box 7072, Kampala, Uganda.
authors.forename: Rhoda K
authors.initials: RK
authors.lastname: Wanyenze
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000600:supply & distribution / Q000627:therapeutic use*; D057191:Capacity Building; D003430:Cross-Sectional Studies; D019033:Delivery of Health Care, Integrated / Q000639:trends; D005260:Female; D017144:Focus Groups; D017575:Gloves, Protective / Q000600:supply & distribution; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000635:transmission; D006280:Health Workforce; D006801:Humans; D019982:Organizational Case Studies; D011181:Postnatal Care / Q000639:trends; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000188:drug therapy*; D011295:Prenatal Care / Q000639:trends; D036301:Qualitative Research; D011933:Reagent Kits, Diagnostic / Q000600:supply & distribution; D012423:Rural Health / Q000208:ethnology; D014454:Uganda; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D011933:Reagent Kits, Diagnostic
keywords: Antenatal services; Integrated HIV; Postnatal service and challenges in providing integrated services