Acknowledgement

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Integration of STI/HIV/AIDS, Malaria and SRH Services into Primary Health Care

All countries that submitted reports responded to this indicator, but some did so only partially. Many countries have plans in place and some are already implementing them, but a few do not yet have the plans. The main challenge noted relates to weak health systems, including inadequate human resources, unsatisfactory coordination, and the fact that some well-funded programmes are still vertical and not ready to take on other programmes (Table 2).

Table 2: Integration of STI/HIV/AIDS, malaria and SRH services into PHC

Indicators	Done	In progress	Not done
Integrated SRHR/STI/HIV/AIDS and malaria policy documents and/or national plans	33 (76.7%)	6 (14%)	4 (9.3%)
Multisector plans supporting SRHR	22 (52.4%)	13 (31%)	7 (16.7%)
Laws/legal instruments dealing with gender-based violence (GBV) in place	30 (69.8%)	9 (20.9%)	4 (9.3%)
Strategies dealing with GBV developed and implemented	22 (51.2%)	19 (44.2%)	2 (4.7%)
Policies and programmes against harmful traditional practices	27 (65.9%)	8 (19.5%)	6 (14.6%)
Training institutions integrating STI/HIV/AIDS and nutrition with SRHR in their curricula	31 (72.1%)	8 (18.6%)	4 (9.3%)

Three (12%) countries reported that integrated SRHR/STI/HIV/AIDS and malaria services are available in 2–40% of their service delivery points, and nine (36%) offer the services in 50–87%. Twelve (33%) countries provide integrated SRHR/STI/HIV/AIDS and malaria services in all their service delivery points. Only one country (4%) does not offer the services in any of its service delivery points (indicator 7).

Strengthening Community-Based STI/HIV/AIDS and SRHR Services

Good practice from Nigeria:

Health partner forums are held regularly.

Strategies for community-based STI/HIV/AIDS and SRHR services are in place in 25 (59.5%) countries. Another 14 (33.3%) say they have initiated action, while 3 (7.1%) have not done so (indicator 8). Many countries have plans in place and some are already implementing them. Communities, including youths and men, should be involved in all levels of planning and implementation for better results.

Repositioning Family Planning as a Key Strategy for Attainment of the MDGS

Only 16 (37.2%) countries reported on the proportion of their health budget that is allocated to family planning commodities. Among these, four (25%) said they do not specifically budget for family planning, as support to this area is derived from the global health budget. Seven (43.8%) countries indicated that they allocate 1–5% of the health budget to family planning commodities, while four (25.2%) others allocate 10–15%. Only one (6.3%) country reserves 16% of its budget to family planning (indicator 9).

Many countries have supportive FP protocols and guidelines, but need to implement them more effectively and to reach all communities in need. This requires skilled human resources, information, education and communication (IEC) activities, and community involvement, as well as regular supplies of commodities. All of these present challenges of one degree or another for many countries to overcome. Policies and strategies have been articulated and adopted in most countries, but their effective operation is still a problem. Education institutions, youth and other groups, and community-based organizations (CBOs) are important partners in this regard.
Supportive protocols and guidelines for family planning are in place in 35 (83.3%) countries. The process is under way in six (14.3%) countries, but in one (2.4%) no action has been taken (indicator 10).

Youth-Friendly SRHR Services Positioned as a Key Strategy for Youth Empowerment, Development and Wellbeing

Nearly two-thirds of the reporting countries – 27 or 64.3% – say that they have policies/strategies in place as well as centres supporting SRHR services for young people. Twelve countries (28.6%) are in the process of developing them, whilst 3 (7.1%) have nothing in place (indicator 11).

In South Africa, the health system is based on the principles of primary health care; and all training institutions incorporate and articulate all dimensions of SRHR according to the National Policy Framework, which is clear on required adolescent health services. This is another example of good practice that needs to be scaled up.

Youth-friendly SRHR services have been integrated into the training curricula in 22 (53.7%) countries, while action has been initiated in 11 (26.8%). Nothing has been done in this area in eight (19.5%) countries (indicator 12).
Although most countries have policies and strategies in place, effective operation is still a challenge. Other challenges include strategies that are not flexible, cultural constraints and high rates of teenage pregnancies in some countries. Education institutions, youth and other organizations, and CBOs are important partners in these efforts.

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