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Integration

HP+ More recent Integration publications are available.

  • These evidence-based advocacy materials, based on Spectrum projections, were produced under the USAID-funded Health Policy Project by the White Ribbon Alliance Nigeria to support national- and state-level advocacy efforts aimed at increasing access to family planning.

  • In order to better understand how FP-HIV integration is being implemented, HPP conducted a situational analysis of the policy and program environment by speaking to 48 national- and district-level stakeholders. The purpose of the interviews was to understand stakeholders’ perspectives on how integration of FP and HIV services as mentioned in the policies was being implemented and how integration of services could further be improved. The semistructured interviews covered various topics including institutional arrangements; processes for addressing integration within health systems such as human resources, commodities, infrastructure, and monitoring and reporting; financing mechanisms; integration within health facilities; the role of the private sector; and behavior change communication (BCC).

    Our findings cover stakeholder perspectives on the institutional arrangements at the national and district levels through which health services and programs are being implemented within the public sector. We further assessed opinions on the progress made in integrating FP and HIV services across the components of the health systems, such as trained healthcare workers, availability of commodities, facility structures to ensure integration, and joint monitoring and reporting. Stakeholders also described how FP and HIV services are currently being implemented in the majority of the facilities and shared some successful pilot programs of integration. This report also describes how information on FP and HIV is currently being addressed in BCC and mass media campaigns, highlights the role of the private sector in assisting to provide FP and HIV services, and also pays special attention to the progress made in reaching youth. 

  • Stigma and discrimination (S&D) confronting people living with HIV and key populations violate people’s rights and can adversely affect HIV prevention, care, and treatment. However, standardized approaches for quantifying and responding to health facility S&D have been unavailable. The USAID- and PEPFAR-funded Health Policy Project led a collaborative global effort to review, prioritize, adapt, and synthesize existing measures and programmatic tools. This effort involved researchers, trainers, other experts, and stakeholders. The resulting stigma-reduction package supports a comprehensive, research-to-action response in health facilities. This poster, presented at the 20th International AIDS Conference in Melbourne, Australia, in July 2014, describes the development of the stigma-reduction package and framework.

  • Developed by the USAID-funded Health Policy Project, the Integrating Gender into Scale-up Mapping Tool is designed to provide program managers with a methodology to systematically integrate gender into scale-up initiatives. The process begins with a gender-based analysis to identify factors that influence women’s and men’s experiences related to health and the best practice to be scaled up. The findings from the analysis are then used to inform development of a scale-up road map with a gender lens. The mapping tool enables the user to identify when gender-based constraints may arise during the scale-up process, and develop strategies to address constraints and opportunities to reduce gender inequality during scale-up. Lastly, the user will develop indicators to monitor both the scale-up process and the gender strategies incorporated into the scale-up process. At the end of the mapping exercise, the user will have a concrete plan outlining the gender barriers that may arise throughout the scale-up process, strategies for addressing these barriers, and indicators to monitor both the scale-up process and the gender strategies incorporated into the process.

    This tool features a gender analysis template and the Integrating Gender into Scale-up Mapping template. Illustrative examples for completing the mapping template are also provided. 

  • In Jamaica, marginalized and key populations including men who have sex with men (MSM) and sex workers experience high levels of HIV and gender based violence (GBV). Stigma and criminalization contribute to violence experienced by key populations, and it further undermines access to HIV prevention and health services. Integrated HIV/GBV services that are client-friendly would alleviate barriers to services yet services and referral networks are inconsistent and largely unavailable in Jamaica. In 2012, Woman, Inc., with support from the USAID- and PEPFAR-funded Health Policy Project (HPP), undertook a pilot intervention in Jamaica to examine the feasibility for integrating GBV and HIV services in health clinics through development of a screening and referral process. This poster summarizing the study was presented at the 20th International AIDS Conference in Melbourne, Australia, in July 2014.

  • In Jamaica, Woman Inc., with support from the Health Policy Project (HPP), implemented a pilot project to assess the feasibility of integrating screenings and referrals for gender-based violence (GBV) with clinical services for HIV and other sexually transmitted infections. The links between GBV and HIV are widely acknowledged, but relatively few people access services for GBV, especially women and key populations with high HIV burdens such as men who have sex with men and sex workers. The pilot project involved gender training for healthcare providers and community agencies, adaptation and implementation of a GBV screening tool, and mapping and strengthening of GBV referral systems. The findings, summarized in this brief, indicate that the pilot enhanced the capacity of HIV healthcare providers to improve access to GBV support services and better meet the needs of their patients, especially women and key populations.

  • At the request of the USAID Mission in Malawi, the USAID-funded Health Policy Project (HPP) undertook a comprehensive facility-based assessment to ascertain the extent to which FP services have been integrated into HIV services in Malawi through different integration models and across various types of facilities (public and non-profit private). The study was also designed to examine how the reproductive rights of people living with HIV (PLHIV) are being respected and addressed through approaches such as PIFP and access to method choice. Finally, the study aimed to identify any systems-level barriers to integration and provide practical recommendations for the Ministry of Health (MOH) and other stakeholders to improve FP-HIV integrated services in Malawi.

  • In June 2014, the government of Haiti passed a new anti-trafficking law to fill a legal gap in the protection of survivors and to increase prosecution of perpetrators of human trafficking. These new legal provisions are particularly important in a country known for being an origin, transit point, and destination for human trafficking. This brief, published by the USAID-funded Health Policy Project AKSE program, aims to explain the rationale, scope, and implications of this new law. It is aimed at international and local organizations working in the field of human rights. This tool is part of a collection of materials developed by HPP AKSE to enhance the environment addressing child protection, trafficking, gender-based rights, sexual and gender-based violence, and to reinforce the capacity of actors in the protection chain and reference networks. 

  • With a high government debt burden and declines in donor assistance, Jamaica faces challenges in sustaining its national HIV and family planning programs. To heighten efficiency and sustainability, the Jamaican Ministry of Health (MOH) integrated elements of its national HIV program into its family planning (FP) program to create a new national agency for sexual health. The new sexual health agency absorbs all the functions previously carried out by the national FP and HIV/STI programs except for treatment and clinical services. In undertaking this reform, the MOH found a dearth of guidance about national HIV-FP program integration. Thus, the MOH collaborated with the USAID- and PEPFAR-funded Health Policy Project to develop this case study assessing lessons to date in Jamaica and next steps.

  • A literature review was conducted to identify and collect existing frameworks and other analytical tools for assessing gender factors within the health policy environment and health programs. Gender tools for family planning/reproductive health (FP/RH), HIV, and maternal and child health were the primary focus. The review, however, also included a search for relevant gender analysis tools outside these health domains and relevant areas outside the health sector. The results of the literature review are intended for use by Health Policy Project (HPP) staff to assist in strengthening gender approaches across HPP core and field support programs.

  • Classified as an upper-middle-income country in 2010, Jamaica is reorganizing its HIV response to heighten efficiency and financial sustainability. A key challenge involves sustaining the program, given declining external assistance and a government in fiscal crisis. Facing this challenge, the Jamaican Ministry of Health has integrated elements of its HIV program into its family planning program to create a new national Ministry of Health (MOH) agency for sexual health. In undertaking this reform, the MOH found a dearth of guidance about national-level integration. Thus, the MOH collaborated with the USAID- and PEPFAR-funded Health Policy Project to assess lessons to date and map next steps. This poster about the study was presented at the 20th International AIDS Conference in Melbourne, Australia, in July 2014.