On Tuesday at the XVIII International AIDS Conference in Vienna I attended a symposium titled “Integrating Sexual and Reproductive Health and Rights and HIV: Lessons from the Field.” The panelists included experts in integration from around the world and provided diverse insight into the field of integration. 

Despite their diverse backgrounds and target populations, a common theme ran throughout the experts’ presentations – integrating already established services at the local level. According to the experts, building on existing facilities and expertise to improve the continuum of care can be more cost effective and require less staff training and fewer additional resources. There is already excellent work being done in many communities, so establishing linkages between these services often makes more sense than working independently from scratch. Provided below are some key elements of integration brought up during the discussion.

 

Marieta de Vos, executive director of Mosaic in South Africa, is working to provide comprehensive services and resources for victims of gender-based violence (GBV), including HIV and reproductive health services. She advised that “coordination at a local level is critical,” and recommended starting the process of integration locally to connect separate but related resources to coordinate their focus on shared target populations.

 

Drasko Kostovski of HERA in Macedonia works to improve sexual and reproductive health rights for Macedonians, with a focus on young people and most at-risk populations (MARPs). Drasko emphasized the importance of staying in touch with the needs of the target population so that services can maintain focus on meeting them comprehensively. He said that integration does not need to be a massive structural change and you should “integrate whatever you have.” Drasko also underscored the significance of monitoring and evaluating programs to inform the improvement and expansion of services.

 

Elizabeth Castillo of Profamilia in Colombia reinforced the message that huge resources are not necessary for integration and that the process can begin on a small scale with the resources and services available. She also stressed the importance of broadening the definition of health to include a wider variety of issues that affect well being, including rights, safe spaces, and healthy relationships.

 

Dudu Simelane, executive director of the Family Life Association in Swaziland, provides family planning and comprehensive sexual and reproductive health services to the people of Swaziland. She emphasized the importance of partnering with other organizations that provide separate but related services to facilitate integration. She also noted that bringing existing services together is often much easier than initiating completely new services.

 

Do you have examples of integrating existing services on a local level? Do you have any other key elements of integration to share?