Introduction
A baseline survey was carried out in Nyeri and Thika districts to
collect pre-intervention data as part of the project evaluation design that
proposed a comparison of pre-intervention and post-intervention measures.
Materials and methods
Client–provider observations in each of the 23 selected facilities were
conducted. A trained nurse observed 24 consecutive new and repeat
client–provider interactions in each facility. A total of 552 family
planning client–provider observations were conducted. Data collection lasted between
five and ten days.
Results and discussion
Results showed major shortcomings in the following areas with regard to
integration: Clinical features of RTIs/STIs were discussed in 14 percent of
consultations. HIV serostatus was discussed in 23.6 percent of the consultations.
Use of brochures and leaflets was recorded in very few consultations (1.1
percent).
Contraceptive methods mostly discussed were injectables
(81.2 percent); combined pill (39.7 percent); condoms for males and females (23.7
percent); IUCD
(22 percent); and progestin-only pill (21.7 percent). The least discussed were
sterilization (6 percent) and emergency contraception (4.9 percent). STI/HIV/AIDS was
discussed in 35.8 percent of consultations. Some 27.7 percent of providers discussed STI/HIV/AIDS
risk factors with their clients. A majority of the providers (72.5 percent) did not
mention the use of condoms. The proportion of providers who encouraged
condom use as another contraceptive method was 18.4 percent. About 38
percent of providers
mentioned voluntary counseling and testing to their clients during the consultations, but only 1.9
percent
offered the clients an opportunity for counseling and testing.
Conclusion and policy implication
The results show a major gap with regard to integration of HIV/AIDS and
RTI/STI within family planning. The gaps identified during the baseline
survey were subsequently taken into consideration while developing materials
for training and in the monitoring and supervision visits. Much effort needs
to go toward strengthening integration of reproductive health and HIV/AIDS activities.
