Integration of Family Planning in HIV/AIDS Program in Solwezi District, Northwestern Zambia: Status and Perspectives

摘要

The aim of this study was to assess the status of Family Planning (FP) service uptake through its integration in HIV program for identification of determinants of its low use in Solwezi district of Zambia. Comparative quantitative FP/HIV data was gathered during quality improvement process from database at Zambia Prevention Care and Treatment Partnership (ZPCT) Consortium for 2012 and 2013. Qualitative data was collected using semi-structured interviews with 29 professionals, at the main urban clinic in the district, from January to June 2013. Two key indicators were assessed: HIV/FP referrals at facility level and male partners’ involvement in seeking HIV/FP services. Referrals between HIV and FP services during the first semester of 2013 increased by 1.0% compared to 2012, whilst male involvement in integrated FP/HIV services remained stagnant at 11%. Low male involvement in FP/HIV service was linked to busy spouses’ work schedules (74%), and lack of knowledge (16%). FP/HIV couple counseling was offered on selected clinic days in 74%, whilst lack of policy implementation encouraging male involvement was noted in 58% of responses. Fear of FP side effects (89%), long distances to the clinic (74%), lack of adequate health information on FP (17%) and unavailability of the preferred FP method (11%) were essential obstacles to service accessibility. Internal systems improvement indicated slight progress in cross-referrals reported. Interventions on the demand side are required, such as in strengthening male involvement in FP/HIV service. FP services in the district would also benefit from increased variety of accessible FP methods.