Development of reproductive health integrated service delivery model for sero-positive women in Addis Ababa, Ethiopia

Abstract

HIV/AIDS affects all people in the world; especially women in reproductive age group are more affected; related to paediatric HIV infections and increased the number of AIDS-related maternal deaths and illnesses. Strategy like mothers' support group (MSG) is important to empower sero-positive women to achieve EMTCT plan and an entry point to access reproductive health services.There are significant factors that prevent the provision of integrated reproductive health (RH) and HIV care related with stigma and discrimination, gender inequality, provider skill, custom of routine HIV care, heavy client loads, poor client provider interactions and lack of provider motivation. The purpose of this study was to develop reproductive healthintegrated model for for sero-positive women in Addis Ababa, Ethiopia. Explanatory Sequential Mixed Method research design was used in Addis Ababa city in seven health centres from selected two sub-cities. Stratified simple random sampling method was applied to select health centres and simple random sampling technique was used to select MSG enrolled Sero-positive women. The in-depth interview and FGD participants were selected through snowball sampling technique. For the quantitative study, data were collected from 352 MSG enrolled Sero-positive pregnant and lactating mothers by recruited data collector nurses. For the qualitative study phase, information were gathered from twelve mentor mothers through in depth interview and three focus group discussion sessions were held to gather information from site coordinators, head of health centres and HIV/AIDS case team leaders or focal persons from sub-city. The findings revealed that even though MSG activities had high impact on strengthening uptake of PMTCT and HIV related services. But study participants mentioned that integration of RH and HIV services is not well established and several constraints of integration were stated in relation to client, health care provider and health facilities. So, hybrid form of integration model was developed based on converging study results. The model was designed for its application that help integration of RH services with existing PMTCT/ MSG services and it helps to ensure the provision of comprehensive and quality care for Sero-positive women. This study recommends the application of hybrid model for the integration of RH service at the community and health facilities level through the coordination of peer mentor mothers and health professionals.