An action plan to integrate abortion care with HIV and family planning services in Ethiopia

Abstract

Integrated health services improve health system efficiency, horizontalization of vertical programmes, and appropriate use of human, financial and medical resources. The integration of maternal health services reduces the risk of unintended pregnancy and the transmission of HIV, especially in a country like Ethiopia, where the prevalence of HIV is high. Thus, delivering integrated abortion care and HIV-family planning (FP) services to clients in a one-stop service can improve maternal health. The study aimed to develop an action plan to facilitate the integration of abortion care with HIV-FP services in public health facilities of the South Nation Nationality and People Region (SNNPR), Ethiopia. An explanatory sequential mixed-method approach was used to undertake the study over three phases. In the first phase, quantitative data were gathered from childbearing-aged women who received abortion care in public healthcare facilities and healthcare providers using face-to-face and selfadministered questionnaires, respectively. The analysed data from phase one and a literature review were used to develop the draft action plan, while programme officers participated in the e-Delphi technique in phase three to validate the draft action plan for the integration of abortion care with FP-HIV services in the public health facilities of Ethiopia. The change logic model was the theoretical framework applied to conduct the study. The inputs of the change logic model in this study included geographic accessibility, human resources, medical resources, infrastructure, fiscal resources, policies, strategies, and guidelines, and behavioural change and communication. Facilities nearer to the community are preferable for maternal health services. In-service training and offering healthcare providers incentives improve integrated maternal health services. Ensuring a consistent supply of medical resources in public healthcare facilities also enhances the integration of abortion care with HIV-FP services. The availability of adequate service-providing areas, water supply, sanitary systems, electricity, and computer connectivity improves the integration of maternal health services. Allocating a budget and providing the service free of charge can enhance the integration of abortion with HIV-FP services. Availing and utilising regulatory documents and improving the community’s awareness on integrated health services can enhance the integration of abortion care with HIV-FP services. The developed action plan will be shared with stakeholders to implement integrated abortion care-HIV-FP services in public health facilities of Ethiopia.