Reproductive health services for populations at high risk of HIV: Performance of a night clinic in Tete province, Mozambique.
Reproductive health services for populations at high risk of HIV: Performance of a night clinic in Tete province, Mozambique.
复制标题
DOI：
10.1186/1472-6963-10-144
复制
发表时间：
2010-05-28
影响因子：
2.8
通讯作者：
Temmerman M
中科院分区：
文献类型：
--
作者：
Lafort Y;Geelhoed D;Cumba L;Lázaro Cd;Delva W;Luchters S;Temmerman M
为高危人群提供艾滋病毒/性传播感染服务有不同的模式。沿着莫桑比克连接马拉维和津巴布韦的太特交通走廊，设立了一个夜间诊所，在下午4点至10点之间开放，对象是女性性工作者和长途卡车司机。该诊所提供免费的个人教育和咨询、避孕套、性传播感染护理、艾滋病毒检测、避孕服务和外联同伴教育。为了评估这种诊所模式，我们评估了相关性，服务利用率，效率和可持续性。2007-2009年，对家庭暴力和土地退化问题进行了调查和统计;采访了28名关键的信息提供者;与莫桑比克和津巴布韦的家庭暴力和土地退化问题以及莫桑比克和马拉维的土地退化问题举行了6次重点小组讨论。分析了诊所产出和成本。估计有4 415名女性工作者在该地区工作，占15-49岁妇女的9%，平均有66辆卡车在诊所附近过夜。目前，平均每月有475名客户到诊所就诊（43%的人是为了避孕，24%的人是为了咨询和检测，23%的人是为了性传播感染护理）。诊所的平均运营成本为每月1 408美元，主要用于人力资源。所有举报人都赞同这一诊所的概念和扩大服务的必要性。脱硫参与者对服务表示高度满意，并提到卫生工作人员的良好接待、较短的等待时间、近距离和免费服务是最重要的。与会者赞成扩大服务范围、地理覆盖面和开放时间。目标人口的规模、客户的满意度和卫生政策制定者的认可证明有理由为MARP保留一个单独的诊所。可通过扩大性健康和生殖健康权利-艾滋病毒/艾滋病服务的范围、调整开放时间、扩大地理覆盖面和针对更多的监测和报告项目来提高成本效益。长期可持续性仍然具有挑战性，需要公私伙伴关系或持续的项目供资。
Different models exist to provide HIV/STI services for most-at-risk populations (MARP). Along the Tete traffic corridor in Mozambique, linking Malawi and Zimbabwe, a night clinic opening between 4 and 10 PM was established targeting female sex workers (FSW) and long-distance truck drivers (LDD). The clinic offers free individual education and counselling, condoms, STI care, HIV testing, contraceptive services and outreach peer education. To evaluate this clinic model, we assessed relevance, service utilisation, efficiency and sustainability. In 2007-2009, mapping and enumeration of FSW and LDD was conducted; 28 key informants were interviewed; 6 focus group discussions (FGD) were held with FSW from Mozambique and Zimbabwe, and LDD from Mozambique and Malawi. Clinic outputs and costs were analysed. An estimated 4,415 FSW work in the area, or 9% of women aged 15-49, and on average 66 trucks stay overnight near the clinic. Currently on average, 475 clients/month visit the clinic (43% for contraception, 24% for counselling and testing and 23% for STI care). The average clinic running cost is US$ 1408/month, mostly for human resources. All informants endorsed this clinic concept and the need to expand the services. FGD participants reported high satisfaction with the services and mentioned good reception by the health staff, short waiting times, proximity and free services as most important. Participants were in favour of expanding the range of services, the geographical coverage and the opening times. Size of the target population, satisfaction of clients and endorsement by health policy makers justify maintaining a separate clinic for MARP. Cost-effectiveness may be enhanced by broadening the range of SRHR-HIV/AIDS services, adapting opening times, expanding geographical coverage and targeting additional MARP. Long-term sustainability remains challenging and requires private-public partnerships or continued project-based funding.