Integrating Family Planning into HIV Clinics: Measuring Contraceptive Prevalence in Lilongwe, 2003

In sub-Saharan Africa, high HIV prevalence coexists with a significant unmet need for family planning. Integrating these services is a strategy proposed to improve reproductive health outcomes for people living with HIV. This study aimed to measure the change in contraceptive prevalence rate among female clients attending HIV clinics following the integration of dedicated family planning services. A secondary objective was to document the implementation process. An operational research study employed a pre-post intervention design. Data were collected through structured interviews with a cohort of women of reproductive age attending selected HIV clinics, conducted before and after service integration. Routine service statistics were also analysed. Following integration, the modern contraceptive prevalence rate among interviewed clients increased substantially. The proportion of women using a modern method rose from a baseline of 23% to 68% post-intervention. Client satisfaction with the convenience of integrated services was also high. The integration of family planning into HIV clinics in this setting was associated with a marked increase in contraceptive use. This suggests service integration is a feasible and effective approach to addressing dual reproductive health needs. Programme planners should consider institutionalising integrated family planning and HIV services. Training for providers on integrated service delivery is essential. Further operational research is needed to assess long-term sustainability and cost-effectiveness. service integration, family planning, HIV, contraceptive prevalence, sub-Saharan Africa, operational research This working paper provides empirical evidence from an African setting on the measurable impact of integrating family planning into HIV clinical services, contributing to the literature on practical models for integrated health service delivery.