Integrating reproductive health: myth and ideology.

摘要: Since 1994, integrating human immunodeficiency virus/sexually transmitted disease (HIV/STD) services with primary health care, as part of reproductive health, has been advocated to address two major public problems: control the spread HIV; and improve women's health. However, integration is unlikely succeed because care political context within which this approach taking place are unsuited task. In paper, a historical comparison made between systems Ghana, Kenya Zambia that South Africa, examine progress on HIV/STD since 1994. Our findings indicate in used mainly by women children meant adding new activities these services. For vertical programmes support services, implies enhanced collaboration rather than merged responsibility. This compromise comprehensive rhetoric selective reality resulted little change existing structures processes; problems have exacerbated external donors. By comparison, Africa achieved through commitment expanding (top-down management systems). The widely despite lack evidence for its feasibility, result convergence four agendas: improving family planning quality; need health; rapid conceptual shifts care. International actors, however, taken account political, financial managerial constraints implementation low-income countries.