Implementation of a sexual and reproductive health service integration model: South African providers’ reports

Abstract

High levels of HIV and unwanted pregnancies have renewed interest in sexual and reproductive health (SRH) services integration. A district-based model for integrating SRH and HIV services was developed and implemented in a district hospital and six feeder clinics in eThekwini District, South Africa. A cross-sectional survey was conducted before and after implementation of this model and explored training and SRH service integration. Forty-six providers participated in baseline, and 44 in an endline survey. Data were descriptively analysed using SPSS. Overall, training undertaken did not change between baseline and endline. The proportion of providers performing HIV testing when providing other SRH services, and those counselling on family planning during HIV counselling and testing and STI services increased at endline. The proportion offering family planning counselling to HIV infected and antenatal clients decreased at endline. Overall, service integration improved modestly after integration model implementation, which could impact positively on uptake of SRH services.