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|Title: ||Are HIV and reproductive health services adapted to the needs of female sex workers? Results of a policy and situational analysis in Tete, Mozambique|
|Authors: ||Lafort, Yves|
Smit, Jenni A.
|Issue Date: ||2016|
|Citation: ||BMC HEALTH SERVICES RESEARCH, 16 (Art N° 301)|
|Abstract: ||Background: In the context of an implementation research project aiming at improving use of HIV and sexual and
reproductive health (SRH) services for female sex workers (FSWs), a broad situational analysis was conducted in Tete,
Mozambique, assessing if services are adapted to the needs of FSWs.
Methods: Methods comprised (1) a policy analysis including a review of national guidelines and interviews with
policy makers, and (2) health facility assessments at 6 public and 1 private health facilities, and 1 clinic specifically
targeting FSWs, consisting of an audit checklist, interviews with 18 HIV/SRH care providers and interviews of 99
HIV/SRH care users.
Results: There exist national guidelines for most HIV/SRH care services, but none provides guidance for care
adapted to the needs of high-risk women such as FSWs. The Ministry of Health recently initiated the process of
establishing guidelines for attendance of key populations, including FSWs, at public health facilities. Policy makers
have different views on the best approach for providing services to FSWs—integrated in the general health services
or through parallel services for key populations—and there exists no national strategy. The most important provider
of HIV/SRH services in the study area is the government. Most basic services are widely available, with the exception of
certain family planning methods, cervical cancer screening, services for victims of sexual and gender-based violence,
and termination of pregnancy (TOP). The public facilities face serious limitations in term of space, staff, equipment,
regular supplies and adequate provider practices. A stand-alone clinic targeting key populations offers a limited range
of services to the FSW population in part of the area. Private clinics offer only a few services, at commercial prices.
Conclusion: There is a need to improve the availability of quality HIV/SRH services in general and to FSWs specifically,
and to develop guidelines for care adapted to the needs of FSWs. Access for FSWs can be improved by
either expanding the range of services and the coverage of the targeted clinic and/or by improving access to
adapted care at the public health services and ensure a minimum standard of quality.|
|Notes: ||Lafort, Y (reprint author), Univ Ghent, Int Ctr Reprod Hlth, Ghent, Belgium.
|ISI #: ||000380645200003|
|Type: ||Journal Contribution|
|Validation: ||ecoom, 2017|
|Appears in Collections: ||Research publications|
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