Strengthening Linkages for Sexual and Reproductive Health, HIV and AIDS: Progress, Barriers and Opportunities for Scaling Up

This 43-page document from the Department for International Development (DFID) Health Resource Centre (HRC) United Kingdom (UK) explores the policy, financing, and institutional factors that enable or constrain the integration through linkages of sexual and reproductive health (SRH) and rights (SRHR) programmes, with policy and programmes for HIV prevention, and AIDS treatment and care.

The brief summarises the main barriers to developing linkages and discusses possible strategies and opportunities for cross-cutting engagement and for strengthening linkages. It explains that, although it is recognised in international-level agreements that SRH, tuberculosis (TB), child health, and HIV/AIDS programme linkages would increase universal access to key services, successful efforts to scale up programme linkages have been limited, despite the existence of and support for these commitments. This, according to this study, is partly because promoting synergistic approaches between these major areas is perceived to be programmatically complex. More significantly, as stated here, existing policy, institutional, and financing arrangements for HIV prevention and AIDS treatment and care, and for SRH programmes are exacerbating the separation of programmes rather than providing incentives to bring them together.

The points that may enable those linkages that are thought to improve universal access, include the following:

• "Improved government and donor co-ordination is helping to develop HIV and AIDS policies and plans for the health sector as a whole, including recent efforts to bring maternal and child health stakeholders together with HIV experts to design support to programmes that take HIV fully into account.
  
• Cross programme working groups and task forces have helped develop linkages, including development of joint guidelines, protocols, training and supervision schedules in SRH and HIV/AIDS programmes.
• Synergies have been promoted through allocation of funds to support cross cutting posts together with programme resources.
• Demonstration projects with scale up plans, together with targeted finance and expert technical assistance help to develop the linkages.
• The role of ‘dual champions’ as high level advocates in national and international agencies has great potential in building support and ownership."