Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #116516

Heidi W. Reynolds, PhD, MPH¹, Jennifer Liku, MA², Ndugga Maggwa, MD, MSc³, Joshua Kimani², Margaret Gitau⁴, and Joel Rakwar, MD, MPH⁵. (1) Health Services Research Division, Family Health International, P.O. Box 13950, Research Triangle Park, NC 27709, 919-544-7040, hreynolds@fhi.org, (2) Family Health International, Africa Regional Office, The Chancery 2nd Floor, Valley Road, PO Box 38835, Nairobi, Kenya, (3) Africa Regional Office, Family Health International, P.O. Box 38835, Nairobi, Kenya, (4) NASCOP, PO Box 19361, Kenyatta Grounds, Nairobi, Kenya, (5) AMKENI, PO Box 10414-00100, ABC Place, 1st Floor, Waiyaki Way, Nairobi, Kenya

Introduction: Offering family planning (FP) to VCT clients may facilitate comprehensive services, expand access to services, improve cost-effectiveness, and prevent unplanned pregnancies. Findings from an assessment of VCT centers in June 2002 in Kenya resulted in a national integration strategy, training curriculum, sensitization workshops, and training of local trainers and VCT providers.

Methods: The objectives of this study are to determine the effectiveness and costs of adding FP services to VCT centres and to determine the effect of adding FP services on the quality of VCT services. This study uses a one-group, pre-and post-test design with twenty VCT clinics. Between baseline (June 2005) and post-test (April 2005) we conduct over 800 VCT client exit interviews, 800 client-provider interactions, 80 provider interviews, and 40 supervisor interviews. The training intervention occurred in November 2004 followed by supportive supervision.

Results: We test two hypotheses: VCT providers will be more likely after the training than before to provide FP methods or refer clients. VCT providers will be more likely after the training than before to identify clients at risk for unintended pregnancy. Quality of VCT care is assessed as are differences in outcomes by provider background.

Discussion: This study addresses a major knowledge gap in the effectiveness of integration. The intervention has required sustained and active leadership from the Ministry of Health. While the study measures whether VCT clients at risk for unintended pregnancy are identified and provided a method or referral, it does not to detect clients' actually use. More research is needed.

Learning Objectives: