HIV/AIDS prevention and control and population/family planning : the potential for integration of programs and activities in sub-Saharan Africa

At the same time, rapid population growth continues to outpace the capacity of African societies to feed, keep healthy, and educate their children, and provide jobs for them when they mature. There are definite points of contact between programs that deal with the threat of AIDS and those that deal with reproductive patterns threatening the lives of mothers and children and the economic well-being of families. The public health community sees a potential for more effectively addressing these two concerns through some degree of integration of population/family planning and HIV/AIDS programs and activities. This report, based on interviews in Washington, D.C., and at WHO in Geneva, and site visits to activities in Zimbabwe, Botswana, and Uganda, assesses the technical and administrative feasibility and program implications for integrating HIV/AIDS activities into established population/family planning programs. Although the study cautions against wholesale integration of activities, it sees many potential advantages to integration under certain circumstances. Possible advantages include: exploiting the experience of NGOs which have been working in the family planning field; moving both family planning and HIV/AIDS programs into a more non-fixed facility, community based mode; addressing target audiences of men and youth more effectively (including more open discussion of human sexuality and contraceptives); and carrying out research or developing policy thrusts common to both interests more efficiently. Some disadvantages include previous disappointing experience with integration of family planning and maternal/child health care; the potential for overloading weak systems; and differences in the opinions of HIV/AIDS and family planning programmers as to which are the more appropriate contraceptives. Individual chapters of the report detail: lessons learned from family planning programs; country experiences of family planning and HIV/AIDS programs; suggested areas for integration of activities; program management concerns; constraints to integration; and recommendations. Includes bibliography. (Author abstract, modified)