How HIV/AIDS scale-up has impacted on non- HIV priority services in Zambia

BMC Public Health

Research Article

Patrick Dicker¹  Aisling Walsh¹  Ruairí Brugha²  Joseph Simbaya³  Phillimon Ndubani³ 

[1] Departmemt of Epidemiology and Public Health Medicine, Division of Population Health Sciences Division, Royal College of Surgeons in Ireland, Dublin, Ireland;Departmemt of Epidemiology and Public Health Medicine, Division of Population Health Sciences Division, Royal College of Surgeons in Ireland, Dublin, Ireland;Department of Global Health Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK;Institute of Economic and Social Research, University of Zambia, Lusaka, Zambia;

关键词: Family Planning;    Antenatal Care;    Reproductive Health Service;    Bacille Calmette Guerin;    District Office;   

DOI  :  10.1186/1471-2458-10-540

 received in 2010-04-21, accepted in 2010-09-08,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundMuch of the debate as to whether or not the scaling up of HIV service delivery in Africa benefits non-HIV priority services has focused on the use of nationally aggregated data. This paper analyses and presents routine health facility record data to show trend correlations across priority services.MethodsReview of district office and health facility client records for 39 health facilities in three districts of Zambia, covering four consecutive years (2004-07). Intra-facility analyses were conducted, service and coverage trends assessed and rank correlations between services measured to compare service trends within facilities.ResultsVCT, ART and PMTCT client numbers and coverage levels increased rapidly. There were some strong positive correlations in trends within facilities between reproductive health services (family planning and antenatal care) and ART and PMTCT, with Spearman rank correlations ranging from 0.33 to 0.83. Childhood immunisation coverage also increased. Stock-outs of important drugs for non-HIV priority services were significantly more frequent than were stock-outs of antiretroviral drugs.ConclusionsThe analysis shows scale-up in reproductive health service numbers in the same facilities where HIV services were scaling up. While district childhood immunisations increased overall, this did not necessarily occur in facility catchment areas where HIV service scale-up occurred. The paper demonstrates an approach for comparing correlation trends across different services, using routine health facility information. Larger samples and explanatory studies are needed to understand the client, facility and health systems factors that contribute to positive and negative synergies between priority services.

【 授权许可】

CC BY   
© Brugha et al; licensee BioMed Central Ltd. 2010