Study of the Integration of Family Planning and VCT/PMTCT/ART Programs in Uganda

Uganda has had laudable success in reducing HIV prevalence in the country and is still focused on strengthening and scaling up prevention treatment and care and support efforts. Currently over 1 million people are estimated to have received HIV counseling and testing over 500000 HIV-positive individuals are receiving palliative care and over 60000 are receiving antiretroviral therapy (ART). Access to services has increased as service delivery sites have expanded into rural areas. With a prevalence rate that appears to have stalled at around 7 percent and new infections continuing to occur among those of reproductive age the epidemic still requires policy and program attention. At the same time Ugandas total fertility rate of 7.0 children per woman is one of the highest in the world. Over 1.4 million women in Uganda report wanting to delay pregnancy space their children or stop childbearing altogether but are not currently using any contraceptive method. High HIV prevalence coupled with high fertility and limited access to family planning (FP) and prevention of mother-to-child transmission (PMTCT) services implies that many children are born to HIV-positive parents. Unintended pregnancies and births often have serious consequences for the health and welfare of mothers and their families as well as economic implications for society. An estimated 80 percent of HIV cases are transmitted sexually and an additional 10 percent are transmitted from mothers to children perinatally or during breastfeeding. Women and men have a need for protection against both unintended pregnancy and HIV infection yet programs to address these two issues have typically been developed implemented and administered separately. Integration of family planning with voluntary counseling and testing (VCT) PMTCT and ART services is preferred by clients and also has the potential for being more cost-efficient. (excerpt)