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How can integrated SRH and HIV service provision be strengthened?

The Integra Initiative employed a ‘programme science’ approach. This meant investing in the provision of integrated SRH and HIV services in each country (Swaziland, Kenya, and Malawi). This investment included in IPPF Member Association health facilities and led to a measurable increase in the number of integrated services provided with the number of SRH and HIV services provided doubling in the Family Life Association of Swaziland between 2008 and 2012, trebled in Family Health Options Kenya and increased 20-fold in Family Planning Association of Malawi over the same period.

These service provision increases resulted from:

  • Infrastructure improvements: Improvements made to the facilities’ infrastructure and equipment.
  • Staff training and mentorship: Staff members in all three countries acquired enhanced skills through training sessions including quality of care, cancer screening, treatment as prevention, voluntary counselling and testing, data and commodity management, and patient privacy and confidentiality.
  • Scaling up outreach and community mobilisation: To improve access to services, FPAM in Malawi increased the number of outreach sites from 24 to 54 and trained peer educators and local chiefs to create demand among clients.
  • Expanding the service package offered: The range of services on offer was expanded by FLAS in Swaziland from 21 in 2008 to 32 in 2012. FPAM increased their range of services from 8 in 2008 to 15 in 2012, by including ART, cervical cancer screening, long term family planning methods, sexual and reproductive health counselling, post-abortion care services and antenatal care services.
  • Improved data capture: The M&E system at FHOK in Kenya was strengthened by developing an electronic clinic information management system.
  • Service quality improvements: 18 FPAM staff members were trained on quality of care with an emphasis on client rights. Committees were set up to monitor the adherence of quality of care standards. At FHOK, quarterly supportive supervision visits and FLAS was identified as a national Centre of Excellence for HIV and SRH integration.


A series of evidence briefs on ‘Steps to Integration’ covers some of the above examples including: