CapacityPlus Technical Brief 5

The US Government’s Global Health Initiative includes increased impact through strategic coordination and integration as one of its seven core principles (United States Government 2011). Consequently, governments and the international community are increasingly paying attention to evaluating health systems components as variables in integration approaches. Yet most of the evaluations of service integration models have virtually ignored the health worker as input to or output of integrated service delivery. This technical brief assesses the evidence on the role of health workers in the integration of family planning (FP) and HIV services and discusses key health worker considerations when integrating FP/HIV services, regardless of the integration model.

We undertook an initial literature review to explore the available evidence on the effects of FP/HIV service integration on the health worker. While the volume of peer-reviewed articles on this topic is not extensive, key sources include reviews by the Cochrane HIV/AIDS Group (Kennedy et al. 2011) and Church and Mayhew (2009). The gray literature also contains briefs and reports from implementing nongovernmental organizations (NGOs), as well as abstracts and presentations from international FP and HIV/AIDS conferences in 2011. The majority of the literature included in this review focused on integrating FP into HIV services. Given that many articles described NGO programs, this focus reflects the facility and/or service types with which the NGOs worked. None of the reviewed articles assessed whether integration of FP into HIV or HIV into FP is more effective.

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