Swaziland has delivered excellent results as a pilot country in the European Union-supported Sexual and Reproductive Health and HIV integration project, implemented in seven countries in the East and Southern African sub-region.
“When the project started almost two years ago no one knew the potential this country had in delivering such excellent results,” said Mr. Edwin Huizing, Director of UNFPA Sub-Regional Office – Johannesburg. “Swaziland is demonstrating that it is possible to provide comprehensive quality SRH-HIV integrated services under one roof and even in the same room by the same provider.”
Mr. Huizing was addressing the second Regional Orientation and M&E meeting for the joint UNAIDS/UNFPA EU-funded regional SRH-HIV linkages project in Mbabane, Swaziland on 21-22 November.The European Union, as part of its health initiative and portfolio, is supporting seven countries in Southern Africa (Botswana, Lesotho, Malawi, Namibia, Swaziland, Zambia and Zimbabwe) in overcoming barriers to strengthening the linkages between Sexual and Reproductive Health (SRH) and HIV policies, programmes and services.
The overall aim of the project, which has been funded at a cost of 7 million Euros, is to promote efficient and effective linkages between HIV and Sexual and Reproductive Health and Rights policies and services, to help strengthen country health systems.
Use of family planning has increased
He said the project had a “slow and bumpy start”, with each of the seven countries undertaking a rapid assessment and then using the results to develop a prioritized package of integrated services. They initiated policy reviews, undertook workforce assessments, trained service providers, and developed M&E tools and operational guidelines. Pilot sites were then set up to begin the work of interlinking SRH and HIV services.
The project is appreciated by its clients and beneficiaries, Mr. Huizing said. “Early findings from Malawi suggest that the defaulters in antiretroviral drugs were reducing in number as clients could access ARTs without being stigmatized as the services are provided five days of the week.” Moreover, the utilization of family planning services has increased, while the work load has reduced as health service providers shared the work load among themselves. There has also been an increase in the number of men in some facilities who escorted their wives to antenatal care and got counselled on SRH and HIV as couples, he said.
“Integrated service provision has proven to be cost-effective, as indicated by studies using, among others, Swaziland's data, which suggests that cost-efficiency is strongest for integrating family planning into HIV services (HTC, ART) and integrating HIV testing into family planning and maternal health services.
“Evidently, in this era of shrinking programme resources as a result of the global financial meltdown, the linking of SRHR and HIV programme approach is surely going to appeal greatly to potential donors and countries that want to make a difference,” he said. “In fact, the EU funding is already proving to be a catalytic resource mobilization platform and has attracted potential additional funding from the Swedish Government amounting to USD 4.6 million.”
Providing guidance to accelerate implementation
At the meeting, the Committee reviewed the project’s progress and undertook a field visit to improve understanding of implementation issues and challenges. Based on the field visit and progress reports, the participants provided further policy and strategic guidance to the project, especially to accelerate the implementation rates. The Annual Work Plans (AWPs) for 2013 were discussed and endorsed at the meeting. The participants also discussed and approved the Terms of Reference, including proposed consultants for the midterm review to be held in the first quarter of 2013.
The participants shared and discussed recent resource mobilization initiatives (UNFPA regular resources, Sida and SDC), and discussed a proposed revised steering committee (smaller rotational membership) in order to improve effectiveness and efficiency.
The project seeks to expand access to integrated HIV and SRH services. Its activities focus on three main areas:
- Support seven countries in Southern Africa to allow full linking of HIV/AIDS and SRH in national health and broader development strategies, plans and budgets;
- Enable three countries (Botswana, Malawi and Swaziland) in Southern Africa to integrate SRH and HIV services better and scale them up effectively;
- Stimulate the formulation and dissemination of lessons learned in the Southern Africa region, formulate best practices and facilitate South-South cooperation in this field.
The project was launched in December 2010, which was followed by a six month inception phase (December 20120 – June 2011) to lay the ground work.
