Estimating the costs of nonintegrated and integrated family planning and HIV facility services in Malawi.

HPP undertook a policy analysis to determine the level of FP-HIV integration that appears in national government policy documents and explored the extent to which the policies outline and address the integration of services. For the purpose of this review we defined policies to include policies strategies guidelines action plans implementation plans clinical and service delivery standards and other similar documents. We retrieved 30 Government of Malawi policies strategies and guidelines on family planning HIV and AIDS and general health of which 19 addressed the provision of FP and/or HIV/AIDS services or discussed integration. There was significant mention on the need to integrate FP services into HIV services for example through ART clinics. The policy documents are well aligned providing supplementary guidance and information but the fact that various elements of integration of FP-HIV services are spread out across a dozen health documents likely results in a disjointed vision for FP-HIV integration in Malawi as well as inconsistent implementation. Furthermore although these documents mention multisectoral collaboration either in the development of policies or the implementation of programs specific details on how to increase and strengthen multisectoral collaboration efforts are unclear. Since the different policies use a variety of approaches to FP-HIV integration the MOH may want to consider developing an implementation and monitoring plan that will outline the various elements of integration noted across all the policy documents and identify how they should be measured.