UCL Institute for Global Health
Diagonal Interventions to Fast-Forward Enhanced Reproductive health (DIFFER)
Duration
5 years commencing 1st October 2011
PI
IGH Staff Involved
Contact
The general objective is to improve sexual and reproductive health for all women by expanding and strengthening sexual and reproductive health services, and providing and testing targeted interventions for female sex workers (FSW) in the context of existing health systems. The research will take place in 3 sub-Saharan African countries and in India.
Improving women’s sexual and reproductive health (SRH)
requires innovative strategies to maximise potential synergies between
components of care. Most adverse reproductive health outcomes stem from
unintended pregnancy, and acquisition and transmission of reproductive tract
infections. Although proven solutions exist, their implementation has been
fragmented, with limited population impact, and little access for populations
most at risk, such as sex workers.
Integration of SRH services is key to
achieving universal access to reproductive health. However, with weakened
health systems and an HIV pandemic, the way forward is uncertain. The essential
package of services and models for delivering them at high coverage in
resource-limited settings are unclear. To address this, we propose a ‘diagonal’ strategy, incorporating both
‘horizontal’ health systems strengthening and more targeted ‘vertical’
approaches. Horizontal programmes can reach large numbers of women, while
vertical programs target high-risk populations, difficult to reach through a
horizontal approach. The aim is improved SRH services through identifying best
practices in delivering a combined package of interventions for general
population women and female sex workers.
The research will occur in Kenya,
Mozambique, South Africa, and Mysore, India by a consortium of 3 African, 1
Indian and 2 European partners. Detailed situation and policy analyses will be
conducted in each country, with key stakeholder and community participation,
and will inform the design of context-specific interventions to be implemented
as feasible and acceptable packages of interventions. We will apply health
systems research methodology to evaluate effectiveness and sustainability, and
to identify the determinants of successful, sustainable and replicable
interventions. This project will help to define packages of SRH services and
models for delivery that meet the needs of all women and impact positively on
their health.
The project has four sites: Kenya (Mombasa), Mozambique (Tete), South Africa
(Durban) and India (Mysore)
- Universiteit Gent - International Centre for Reproductive Health (UG-ICRH)
- Ashodaya Samithi, India
- International Centre for Reproductive Health Association, Kenya (ICRH-K)
- International Centre for Reproductive Health Association Mozambique
- University of The Witwatersrand - MatCH & Centre for Health Policy
