Integrate FP/LAPMs Into Other Services

Since the mid-1990s, the international development and public health communities have embraced a more comprehensive reproductive health (RH) agenda and have sought to meet clients’ RH needs more holistically, in part by providing a range of services in an integrated fashion. Developing countries have attempted to integrate family planning (FP) with a variety of services—e.g., with the management of sexually transmitted infections (STIs); with a range of HIV and AIDS services; with postpartum services; and as part of postabortion care.

The need is clear: Each year, approximately 600,000 women die worldwide as a direct result of complications that arise during pregnancy, delivery, or the postpartum period—with unsafe abortion accounting for 13% of all maternal deaths each year. Moreover, for the approximately 20 million women of childbearing age living with HIV, FP can play an important role in limiting the epidemic, preventing mother-to-child transmission of HIV, and helping mothers deliver when they are healthy. Strengthening FP in postabortion care and other RH services can have a sizable impact on reducing maternal morbidity and mortality, on preventing HIV transmission, and on increasing child survival.

Integration helps health care providers engage a client to address broader health and social needs than those prompting his or her initial visit. With dwindling budgets and with increasing human resource constraints, there is a growing interest in making integration operational. The ACQUIRE Project embraced integration as a key strategy for maximizing access to services. Its approach was to strengthen the existing FP component overall; to revitalize the FP element within a care package (e.g., postabortion and postpartum); and/or to create FP linkages where they were lacking, as in fistula care and HIV services. To guide programming for integration, ACQUIRE developed Family Planning–Integrated HIV Services: A Framework for Integrating Family Planning and Antiretroviral Therapy Services, which is rooted in the fundamentals of care (i.e., informed choice, clinical safety, and ongoing quality improvement).

This section of the archive contains resources that may be of use in your work setting. These include reports and lessons learned on how ACQUIRE applied the programming principles that underpin the fundamentals of care and the integration framework to integrate FP into HIV in Ghana, South Africa, and Uganda. Also, you will also find several other tools and curricula that helped guide ACQUIRE’s integration work, including a framework and curriculum for Integrating Family Planning with HIV Prevention, Care, and Treatment Services; Hormonal Contraception and HIV Technical Guidance; and curricula for postpartum IUD provision and for counseling of fistula patients. This section is rounded out with posters, presentations, and stories from the field that put a human face to those who served as champions.