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Needs and Opportunities for Sexual and Reproductive Health Programmes and Services in the Context of the HIV/AIDS Epidemic ( C. Ouedraogo and A. Ilinigumugabo ). Sanda Ojiambo IPPF Africa Regional Office 3 rd Africa Conference on Sexual Health and Rights. Presentation Outline.

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sanda ojiambo ippf africa regional office 3 rd africa conference on sexual health and rights

Needs and Opportunities for Sexual and Reproductive Health Programmes and Services in the Context of the HIV/AIDS Epidemic(C. Ouedraogo and A. Ilinigumugabo)

Sanda Ojiambo

IPPF Africa Regional Office

3rd Africa Conference on Sexual Health and Rights

From choice, a world of possibilities

presentation outline
Presentation Outline
  • Organisational and Contextual Background
  • Study Purpose
  • Methodology
  • Findings
  • Reccomendations
background to ippfar
Background to IPPFAR
  • IPPFAR –service provider and advocate for SRH& R with Member Associations in 44 countries
  • Traditionally known for Family Planning but shifted towards comprehensive SRHR
  • 2005 Strategic Framework - The 5As – Adolescents and Young People; HIV/AIDS;Access to Services; Abortion, Advocacy
contextual background
Contextual Background
  • ICPD called for comprehensive approaches to SRHR
  • Global, regional and national responses to HIV/AIDS have been strengthened
  • Increasing opposition to sexual rights and universal access
  • SRH indicators in SSA show limited improvement in various countries
study purpose
Study Purpose
  • To assess the degree to which IPPFAR MAs had diversified their SRH services
  • To identify the extent to which global trends and policy/programme responses impacted on service delivery among IPPFAR MAs
  • To identify mechanisms to strengthen comprehensive responses to SRHR
methodology and data sources
Methodology and Data Sources
  • Desk Review
  • Data Sources (36 MAs) from 2001-2005
    • Annual Performance Reports
    • Service Statistic Reports

Limitations

    • Covers 80% of MAs
    • Self reporting biases
findings reproductive health services
Findings – Reproductive Health Services
  • Question: Were there more RH services offered?
  • Findings:
    • 57% of MAs reported a decline in visits
      • 85% of these reported declines of more than 50%
    • 43% of MAs reported an increase in visits
      • 40% of these reported an over 200% increase
    • Trends in CYP vs. visits
  • Context: IPPFAR focused efforts to implement the shift from family planning to integrated SRH. GGR implemented 2001and reinstated in 2005 and increased opposition to SRHR
findings service delivery coverage
Findings – Service Delivery Coverage
  • Question: What was the change in number of service delivery outlets?
  • Findings
    • 50% of MAs had closed more than half of their service delivery points between 2001 and 2004
    • 50% of MAs significantly increased the number of service delivery points
  • Context: IPPFAR works to increase access to SRH services for hard to reach and underserved populations
findings diversification of services
Findings – Diversification of Services
  • Question: What was change in non contraceptive services offered by the MAs?
  • Findings
    • Three clear trends: reduction of Family Planning, slow diversification and rapid diversification
    • 38% of MAs showed reduction in FP and increase in other services
    • 38% of MAs showed slow diversification
    • 24% of MAs showed rapid diversification
    • But rapid diversification not necessarily linked with expansion of service outlets

Context: IPPFAR Member Associations have diversified their service package from Family Planning to SRH

findings funding for services
Findings – Funding for Services
  • Question: What was the impact of changes in global operating environment on funding trends of IPPFAR MAs (2002-2005)
  • Findings
    • 74% MAs with 2005 income less than 2002
    • 92% MAs reported decrease in income (2004-2005)
    • Only1 MA with a steady increase

Context: Funding for HIV/AIDS is verticalised. Global Gag Rule further reduced funding for integrated responses

summary of trends
Summary of Trends
  • IPPFAR shift implemented at a time of changes in national and global perspectives
  • The Global Gag Rule and verticalised responses caused income losses (est US$18 million)
  • Trends vary but some adverse effects on SRH services, diversification and service delivery package applicable to the overall SRHR arena
  • Missed opportunity to provide integrated SRH services
ippfar responses
IPPFAR Responses
  • Diversification of funding sources
  • Continued integration of services
  • Promotion and advocacy for integration of HIV/AIDS into SRH and vice versa
recommendations in support of integration of services
Recommendations In Support of Integration of Services
  • Comprehensive responses
  • Optimalisation of resources- human, time, financial
  • Minimizes the negative effect of referrals
  • Promotes universal access to SRH information and services