Feasibility of implementing an integrated hybrid model of service delivery for AGYW sexual and reproductive health in South Africa

在南非实施 AGYW 性健康和生殖健康综合混合服务提供模式的可行性

• 批准号: MR/T003944/1
• 负责人: Diantha Pillay
• 金额: $ 20.23万
• 依托单位: University of the Witwatersrand
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2020
• 资助国家: 英国
• 起止时间: 2020 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FT003944%2F1
• 关键词: Feasibility; implementing; integrated; hybrid; model

Adolescent girls and young women (AGYW) experience significant health challenges including HIV infection, unwanted teenage pregnancies and sexually transmitted diseases in South Africa. Challenges exist with the uptake and utilization of sexual and reproductive health services for AGYW and there are a number of missed opportunities with the health system to provide prevention and care to AGYW. There is a renewed drive for service integration by policy makers to integrate SRH services with newly emerging HIV prevention and treatment services, in addition to scaling up access to prevention, care and treatment of STI's at a primary healthcare level. Current isolated service delivery models adds time and cost to clinic facilities and may be seen as a barrier to accessing care, as young people may have less access to cash, competing demands and less control over their time. There is limited data on effective delivery models for integrated interventions for young populations, therefore this study aims to determine the feasibility of implementing an integrated hybrid model of service delivery for adolescent girls and young women (AGYW) sexual and reproductive health (SRH) at selected facilities in South Africa. The integrated service delivery model will be a hybrid model comprising of both integration of contraceptive, STI/HIV transmission prevention and mental health screening with linkage to care services for HIV treatment, PrEP and psychosocial support. The linkages to appropriate care should be facilitated by health connectors. In order to determine whether such an intervention would be feasible to implement at selected facilities, this study will 4 elements, namely acceptability, demand, practicality and adaptation using the following objectives: (1) determine client, provider and key informant acceptability of the integrated hybrid model for SRH service delivery for AGYW, (2) assess demand and preference for integrated SRH services amongst AGYW, (3) determine the practicality of delivering integrated hybrid model for SRH service delivery for AGYW in a resource constrained setting, and (4) determine current level of integration and the adaptations needed to implement the integrated hybrid model for SRH service delivery for AGYW.

在南非，少女和年轻妇女面临着巨大的健康挑战，包括艾滋病毒感染、意外怀孕和性传播疾病。在吸收和利用AGYW的性健康和生殖健康服务方面存在挑战，保健系统错失了一些向AGYW提供预防和护理的机会。政策制定者再次推动服务整合，将SRH服务与新出现的艾滋病毒预防和治疗服务相结合，此外还扩大了在初级医疗保健层面获得性传播感染的预防、护理和治疗的机会。目前孤立的服务提供模式增加了诊所设施的时间和成本，并可能被视为获得护理的障碍，因为年轻人获得现金的机会可能较少，竞争的需求和对时间的控制较少。关于为青年人口提供综合干预的有效提供模式的数据有限，因此，本研究旨在确定在南非选定的设施中实施为青春期女孩和年轻妇女(AGYW)性健康和生殖健康(SRH)提供服务的综合混合模式的可行性。综合服务提供模式将是一种混合模式，既包括避孕、性传播感染/艾滋病毒传播预防和精神健康筛查，又与艾滋病毒治疗、预防艾滋病和心理社会支助的护理服务挂钩。与适当护理的联系应由健康连接者提供便利。为了确定在选定的设施中实施这种干预措施是否可行，本研究将利用以下目标确定4个要素，即可接受性、需求、实用性和适应性：(1)确定为AGYW提供SRH服务的综合混合模式的客户、提供者和主要信息者的可接受性；(2)评估AGYW对综合SRH服务的需求和偏好；(3)确定在资源受限的情况下为AGYW提供SRH服务的综合混合模式的可行性；以及(4)确定当前的整合水平和实施AGYW的SRH服务提供的综合混合模式所需的适应。