Integration of STI and HIV/AIDS with MCH-FP Services: A case study of the Nakuru Municipal Council\u27s project on strengthening STD/AIDS control

Kenya’s Nakuru Municipal Council (NMC) operates five clinics located primarily in residential areas with high concentrations of people. The clinics provide basic antenatal, child welfare, STI, and other curative services, and family planning services are available at four of the clinics. One provincial referral hospital operated by the Ministry of Health also provides MCH-FP and HIV/STI services in a special STI treatment clinic. The seven public health facilities in Nakuru Municipality are participating in a collaborative project with the Department of Community Health at the University of Nairobi, the University of Manitoba in Canada, and the Nairobi Municipal City Council. The goal is to reduce the incidence of STD\u27s, including HIV/AIDS in Kenya, through strengthening management of STDs and AIDS at the health facilities and establishing sustainable community-based STD/AIDS control activities with an emphasis on women\u27s participation. This report describes a case study of the integration activities being undertaken by the NMC. NMC clinics have adequate basic infrastructure to provide MCH-FP and STI/HlV/AlDS services using an integrated approach, however they lack basic equipment and supplies to support the integration of these services

Improving the management of STIs among MCH/FP clients at the Nakuru Municipal Council health clinics

In an effort to address the global crisis of HIV/AIDS and to reduce the spread of other sexually transmitted infections (STIs), maternal and child health/family planning (MCH/FP) programs have attempted to integrate the management of STIs into their services. This integration was endorsed at the 1994 International Conference on Population and Development in Cairo. However, as noted in this report, programs have encountered a number of difficulties as they try to effectively manage STIs in an MCH/FP setting. In particular, the effective detection and treatment of STIs has proven difficult among MCH/FP populations. This current study was developed to help improve integration efforts and to contribute to a reduction in the prevalence and spread of STIs among women receiving MCH/FP services from the Nakuru Municipal Council health clinics in Kenya. The project looked at the validity of the current syndromic management approach and explored various ways to improve its approach through the incorporation of risk assessment

Studying social accountability in the context of health system strengthening: innovations and considerations for future work

Abstract There is a growing body of research on the role of social accountability in bringing about more accessible and better-quality healthcare. Here, we refer to social accountability as “citizens’ efforts at ongoing meaningful collective engagement with public institutions for accountability in the provision of public goods” (Joshi, World Dev 99:160–172, 2017). These processes have multiple interrelated components and sub-processes and engage a range of actors in community-driven, often unpredictable and context-dependent actions, which pose many methodological challenges for researchers. In June 2017, scientists and implementers working in this area came together to share experiences, discuss approaches, identify research gaps and consider directions for future studies. This paper shares learnings from this discussion. In particular, participants considered (1) how best to define and measure the complex processual nature of social accountability; (2) the study of social accountability as an inherently political process; and (3) the challenges of generalising unpredictable, community-driven and context-dependent processes. Key among a range of consensus areas was the need for researchers to capture a broader range of outcomes and better understand the nuances of implementation processes in order to effectively test theories and assumptions. Furthermore, power relationships are inherent in social accountability and the research process itself. In presenting details on these deliberations, we hope to prompt a wider discussion on the study of social accountability in health programming