Strategies to facilitate the integration of family planning and HIV services at the public health centre level in Addis Ababa, Ethiopia

Abstract

Improving the implementation of family planning through integration with HIV services is vital to reduce maternal and child morbidity and mortality that has been a concern especially in developing countries like Ethiopia (UNFPA 2016). The aim of this study was to develop a strategic plan that could facilitate the implementation of an integrated family planning and HIV services at the public health centre level. The researcher utilized an explanatory sequential mixed method design with quantitative data collected in the first phase and qualitative data collected in the second phase. Data were collected from 403 clients in face-to-face structured interviews and from 305 service providers by means of a self-administered questionnaire. Descriptive analysis was applied to describe the findings of the study. Significance testing between variables was computed by odds ratio, p-value and 95% confidence interval. Bivariate and multi-variate logistic regressions were used for the analysis. In Phase 1, awareness of family planning methods, male involvement, marital status, client satisfaction, family income, waiting time, training, awareness of policies/guideline and transport availability were statistically significant challenges identified by clients and service providers. The client and service provider respondents identified previous use of family planning, men’s involvement, client satisfaction, availability of behavioural change communication materials, accessibility, budget, infrastructure and medical resources as opportunities. In phase 2, the researcher utilized the nominal group technique (NGT) to collect qualitative data from programme officers. Twenty-four programme officers from 10 sub city health offices, city and national level participated in two nominal groups, consisting of 12 participants each. Multiple group analysis was used to analyse the data from the nominal groups. The five strategies ranked as the most important were leadership and management; capacity building; implementation of policies and guidelines; advocacy/awareness, and infrastructure. The findings in phase 1 and phase 2 formed the basis for the development of a strategic plan using the process planning model. The strategic plan was developed and validated with the active participation and involvement of programme officers. The plan is intended to be implemented by service providers and programme officers to facilitate the implementation of integrated family planning and HIV services at the public health centre level.