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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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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 • Organisational and Contextual Background • Study Purpose • Methodology • Findings • Reccomendations
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 • 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 • 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 • 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 • 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 • 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 • 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 • 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 • 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 • 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 • Comprehensive responses • Optimalisation of resources- human, time, financial • Minimizes the negative effect of referrals • Promotes universal access to SRH information and services