Exploring the feasibility of service integration in a low-income setting: A mixed methods investigation into different models of reproductive health and HIV care in Swaziland

PLoS ONE

Volumn 10, Issue 5, 2015, Pages

  Church, Kathryn ^a   Wringe, Alison ^a   Lewin, Simon ^b,c   Ploubidis, George B ^a   Fakudze, Phelele ^d   Initiative, Integra ^e   Mayhew, Susannah H ^a  

^a LONDON SCHOOL OF HYGIENE AND TROPICAL MEDICINE   (United Kingdom)

^b NORWEGIAN KNOWLEDGE CENTRE FOR THE HEALTH SERVICES   (Norway)

^c SOUTH AFRICAN MEDICAL RESEARCH COUNCIL   (South Africa)

^d UNIVERSITY OF LONDON   (United Kingdom)

^e PSI   (Swaziland)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; ARTICLE; CONTRACEPTION; FAMILY PLANNING; FEASIBILITY STUDY; FEMALE; HEALTH CARE DELIVERY; HEALTH CARE NEED; HEALTH EDUCATION; HUMAN; HUMAN IMMUNODEFICIENCY VIRUS INFECTION; INTEGRATED HEALTH CARE SYSTEM; LOWEST INCOME GROUP; MALE; MARRIAGE; PATIENT CARE; PREGNANCY; QUALITATIVE ANALYSIS; REPRODUCTIVE HEALTH; SEXUAL BEHAVIOR; SOCIAL INTERACTION; SWAZILAND; YOUNG ADULT; DEVELOPING COUNTRY; HEALTH SERVICE; HIV INFECTIONS; INTERVIEW; MIDDLE AGED; NONBIOLOGICAL MODEL; ORGANIZATION AND MANAGEMENT;

ADULT; DELIVERY OF HEALTH CARE, INTEGRATED; DEVELOPING COUNTRIES; FEASIBILITY STUDIES; FEMALE; HIV INFECTIONS; HUMANS; INTERVIEWS AS TOPIC; MIDDLE AGED; MODELS, ORGANIZATIONAL; PREGNANCY; REPRODUCTIVE HEALTH SERVICES; SWAZILAND; YOUNG ADULT;

EID: 84929379690     PISSN: None     EISSN: 19326203     Source Type: Journal    
DOI: 10.1371/journal.pone.0126144     Document Type: Article

References (40)

1. Rabkin M, El-Sadr WM, De Cock KM. The impact of HIV scale-up on health systems: A priority research agenda. J Acquir Immune Defic Syndr. 2009;52 Suppl 1:S6-11. Epub 2009/11/05. doi: 10.1097/QAI.0b013e3181bbcd6900126334-200911011-00003 [pii]. PMID: 19858943.
2. McCoy D, Chopra M, Loewenson R, Aitken JM, Ngulube T, Muula A, et al. Expanding access to antiretroviral therapy in sub-saharan Africa: avoiding the pitfalls and dangers, capitalizing on the opportunities. Am J Public Health. 2005;95(1):18-22. Epub 2004/12/30. 95/1/18 [pii] doi: 10.2105/AJPH.2004. 040121 [doi]. PMID: 15623853.
3. Coovadia H, Bland R. From Alma-Ata to Agincourt: primary health care in AIDS. Lancet. 2008;372(9642):866-8. Epub 2008/09/16. S0140-6736 (08) 61373-2 [pii] doi: 10.1016/S0140-6736 (08) 61373-2 [doi]. PMID: 18790293.
4. Gilks CF, Crowley S, Ekpini R, Gove S, Perriens J, Souteyrand Y, et al. The WHO public-health approach to antiretroviral treatment against HIV in resource-limited settings. Lancet. 2006;368(9534):505-10. Epub 2006/08/08. S0140-6736 (06) 69158-7 [pii] doi: 10.1016/S0140-6736 (06) 69158-7 [doi]. PMID: 16890837.
5. El-Sadr WM, Abrams EJ. Scale-up of HIV care and treatment: can it transform healthcare services in resource-limited settings? AIDS. 2007;21(suppl 5):S65-S70. doi: 10.1097/01.aids.0000298105. 79484.62 PMID: 18090271
6. Sibide M, Buse K. Strength in Unity. Bull World Health Organ. 2009;87(11):806-7. PMID: 20072759
7. UNFPA. The New York Call to Commitment: Linking HIV/AIDS and Sexual and Reproductive Health. New York: United Nations Population Fund; 2004.
8. Reynolds HW, Janowitz B, Wilcher R, Cates W. Contraception to prevent HIV-positive births: current contribution and potential cost savings in PEPFAR countries. Sex Transm Infect. 2008;84 Suppl 2:ii49-53. Epub 2008/10/01. 84/Suppl-2/ii49 [pii] doi: 10.1136/sti.2008.030049 [doi]. PMID: 18799493.
9. IPPF. Positive prevention. Prevention strategies for people living with HIV. Chennai: International Planned Parenthood Federation, 2010.
10. Myer L, Rabkin M, Abrams EJ, Rosenfield A, El-Sadr WM. Focus on women: linking HIV care and treatment with reproductive health services in the MTCT-Plus Initiative. Reprod Health Matters. 2005;13(25):136-46. Epub 2005/07/23. PMID: 16035607.
11. Lush L, Cleland J, Walt G, Mayhew S. Integrating reproductive health: myth and ideology. Bull World Health Organ. 1999;77(9):771-7. Epub 1999/10/27. PMID: 10534902.
12. Lush L. Service integration: An overview of policy developments. Int Fam Plan Perspect. 2002;28(2):71-6.
13. Mutemwa R, Mayhew S, Colombini M, Busza J, Kivunaga J, Ndwiga C. Experiences of health care providers with integrated HIV and reproductive health services in Kenya: a qualitative study. BMC Health Serv Res. 2013;13(1):18. Epub 2013/01/15. 1472-6963-13-18 [pii] doi: 10.1186/1472-6963-13-18 PMID: 23311431.
14. Uebel K, Guise A, Georgeu D, Colvin C, Lewin S. Integrating HIV care into nurse-led primary health care services in South Africa: a synthesis of three linked qualitative studies. BMC Health Serv Res. 2013;13:171. Epub 2013/05/08. doi: 10.1186/1472-6963-13-171 1472-6963-13-171 [pii]. PMID: 23647922; PubMed Central PMCID: PMC3652780.
15. Shelton J. The provider perspective: human after all. Int Fam Plan Perspect. 2001;27(3):152-61.
16. Smit JA, Church K, Milford C, Harrison AD, Beksinska ME. Key informant perspectives on policy- and service-level challenges and opportunities for delivering integrated sexual and reproductive health and HIV care in South Africa. BMC Health Serv Res. 2012;12:48. Epub 2012/03/01. 1472-6963-12-48 [pii] doi: 10.1186/1472-6963-12-48 PMID: 22369041; PubMed Central PMCID: PMC3311559.
17. Reeves S, Lewin S, Zwarenstein M, Espin S. Interprofessional teamwork in health and social care. London: Blackwell; 2010.
18. Topp SM, Chipukuma JM, Chiko MM, Matongo E, Bolton-Moore C, Reid SE. Integrating HIV treatment with primary care outpatient services: opportunities and challenges from a scaled-up model in Zambia. Health Policy Plan. 2013;28(4):347-57. Epub 2012/07/14. doi: 10.1093/heapol/czs065 PMID: 22791556; PubMed Central PMCID: PMCPMC3697202.
19. Church K, Mayhew SH. Integration of STI and HIV prevention, care, and treatment into family planning services: a review of the literature. Stud Fam Plann. 2009;40(3):171-86. PMID: 19852408
20. Schneider H, Boulle A, Coetzee D, Engelbrecht M, Goudge J, van Rensburg-Bonthuyzen E, et al. Models of care for antiretroviral service delivery in three provinces: Western Cape, Free State and Gauteng Johannesburg: University of Witwatersrand 2008.
21. Lindegren ML, Kennedy CE, Bain-Brickley D, Azman H, Creanga AA, Butler LM, et al. Integration of HIV/AIDS services with maternal, neonatal and child health, nutrition, and family planning services. Cochrane Database Syst Rev. 2012;9:CD010119. Epub 2012/09/14. doi: 10.1002/14651858. CD010119 PMID: 22972150.
22. Ekman B, Pathmanathan I, Liljestrand J. Integrating health interventions for women, newborn babies, and children: a framework for action. Lancet. 2008;372(9642):990-1000. Epub 2008/09/16. S0140-6736 (08) 61408-7 [pii] doi: 10.1016/S0140-6736 (08) 61408-7 [doi]. PMID: 18790321.
23. UNAIDS. UNAIDS Report on the Global AIDS Epidemic 2012. Geneva: United Nations Joint Programme on HIV/AIDS 2012.
24. NERCHA. National Strategic Framework for HIV and AIDS 2009-2014. Mbabane: National Emergency Response Council on HIV and AIDS 2009. doi: 10.1371/journal.pmed.1001641 PMID: 24800840
25. Yin R. Case Study Research, Third Edition. 3rd Edition ed. London: Sage 2003.
26. Warren CE, Mayhew SH, Vassall A, Kimani JK, Church K, Obure CD, et al. Study protocol for the Integra Initiative to assess the benefits and costs of integrating sexual and reproductive health and HIV services in Kenya and Swaziland. BMC Public Health. 2012;12:973. Epub 2012/11/15. doi: 10.1186/1471-2458-12-973 1471-2458-12-973 [pii]. PMID: 23148456; PubMed Central PMCID: PMC3529107.
27. Church K, Wringe A, Fakudze P, Kikuvi J, Simelane D, Mayhew SH. The relationship between service integration and client satisfaction: a mixed methods case study within HIV services in a high prevalence setting in Africa. AIDS Patient Care STDS. 2012;26(11):662-73. Epub 2012/10/20. doi: 10.1089/apc. 2012.0191 PMID: 23078548.
28. Church K, Wringe A, Fakudze P, Kikuvi J, Simelane D, Mayhew SH. Are integrated HIV services less stigmatizing than stand-alone models of care? A comparative case study from Swaziland. J Int AIDS Soc. 2013;16(1):17981. Epub 2013/01/23. doi: 10.7448/IAS.16.1.17981 17981 [pii]. PMID: 23336726; PubMed Central PMCID: PMC3545202.
29. Church K, Wringe A, Fakudze P, Kikuvi J, Nhlabatsi Z, Masuku R, et al. Reliance on condoms for contraceptive protection among HIV care and treatment clients: a mixed methods study on contraceptive choice and motivation within a generalised epidemic. Sex Transm Infect. 2014; Forthcoming.
30. Glaser BG, Strauss AL. Discovery of Grounded Theory: Strategies for Qualitative Research. New York: AldineTransaction; 1999.
31. Pawson R. Realist methodology: the building blocks of evidence. In: Pawson R, editor. Evidencebased Policy A Realist Perspective. London SAGE; 2006. p. 16-37.
32. Church K. Meeting the sexual and reproductive health needs of HIV care and treatment clients in Swaziland: A comparative case study of integrated and stand-alone models of care [PhD Thesis]. London London School of Hygiene & Tropical Medicine; 2011.
33. Leon N, Lewin S, Mathews C. Implementing a provider-initiated testing and counselling (PITC) intervention in Cape town, South Africa: a process evaluation using the normalisation process model. Implement Sci. 2013;8:97. Epub 2013/08/27. 1748-5908-8-97 [pii] doi: 10.1186/1748-5908-8-97 PMID: 23972055; PubMed Central PMCID: PMC3765808.
34. Dwamena F, Holmes-Rovner M, Gaulden CM, Jorgenson S, Sadigh G, Sikorskii A, et al. Interventions for providers to promote a patient-centred approach in clinical consultations. Cochrane Database Syst Rev. 2012;12:CD003267. Epub 2012/12/14. doi: 10.1002/14651858. CD003267.pub2 PMID: 23235595.
35. Dixon-Woods M, Suokas A, Pitchforth E, Tarrant C. An ethnographic study of classifying and accounting for risk at the sharp end of medical wards. Soc Sci Med. 2009;69(3):362-9. Epub 2009/06/19. S0277-9536 (09) 00324-4 [pii] doi: 10.1016/j.socscimed.2009.05.025 PMID: 19535193.
36. Reeves S, Lewin S. Interprofessional collaboration in the hospital: strategies and meanings. J Health Serv Res Policy. 2004;9(4):218-25. Epub 2004/10/29. doi: 10.1258/1355819042250140 [doi]. PMID: 15509407.
37. Baumgartner JN, Green M, Weaver MA, Mpangile G, Kohi TW, Mujaya SN, et al. Integrating family planning services into HIV care and treatment clinics in Tanzania: evaluation of a facilitated referral model. Health Policy Plan. 2014;29(5):570-9. doi: 10.1093/heapol/czt043 PMID: 23894070; PubMed Central PMCID: PMC4184336.
38. Georgeu D, Colvin CJ, Lewin S, Fairall L, Bachmann MO, Uebel K, et al. Implementing nurse-initiated and managed antiretroviral treatment (NIMART) in South Africa: a qualitative process evaluation of the STRETCH trial. Implement Sci. 2012;7:66. Epub 2012/07/18. 1748-5908-7-66 [pii] doi: 10.1186/1748-5908-7-66 PMID: 22800379; PubMed Central PMCID: PMC3464669.
39. Grossman D, Onono M, Newmann SJ, Blat C, Bukusi EA, Shade SB, et al. Integration of family planning services into HIV care and treatment in Kenya: a cluster-randomized trial. AIDS. 2013;27 Suppl 1:S77-85. Epub 2013/10/23. doi: 10.1097/QAD.0000000000000035 00002030-201310001-00009 [pii]. PMID: 24088687.
40. Harrell FE Jr., Lee KL, Mark DB. Multivariable prognostic models: issues in developing models, evaluating assumptions and adequacy, and measuring and reducing errors. Stat Med. 1996;15(4):361-87. Epub 1996/02/28. 10.1002/(SICI) 1097-0258 (19960229) 15:4<361::AID-SIM168>3.0. CO;2-4 [pii] 10.1002/(SICI) 1097-0258 (19960229) 15:4<361::AID-SIM168>3.0. CO;2-4 [doi]. PMID: 8668867.