Diagonal Interventions to Fast Forward Enhanced Reproductive Health (DIFFER)

 

To improve SRH for all women by expanding and strengthening SRH services, and providing and testing targeted interventions for female sex workers in the context of existing health systems

 

To assess the feasibility of integrating a combination of new SRH services into existing services for general population women;
To assess the feasibility of linking and/or integrating services for FSW into existing services for the general population;
To assess the feasibility of participatory processes involving FSW, local service delivery partners and the general population in design and delivery of improved SRH services for FSW;
To design packages of SRH care interventions which are feasible, appropriate, sustainable, effective, scalable and tailored to the conditions of each study site;
To implement and evaluate site-specific packages of improved SRH services delivered at facilities, at targeted services, and within the community;
To evaluate effectiveness of 3 years of strengthened services by conducting a cross-country assessment of the determinants of improved SRH services and outcomes pre and post-intervention, and to measure cost effectiveness of improved SRH care for FSW;
To engage policy makers from the outset in planning, implementing, evaluating and expanding the project;
To inform SRH policy and service delivery guidelines development that serve the needs of the general population and vulnerable groups such as FSW.

 

Case study at 4 different sites: Mombasa, Kenya; Tete, Mozambique; Durban, South Africa; and Mysore, India
Pre-post intervention comparison
Combination of quantitative and qualitative research methods                 

 

Policy analysis identifying current policies and policy gaps
Detailed situation analysis of the scope and quality of existing SRH services
Design a package of SRH interventions and services, based on acquired knowledge of cost, context and preference of local stakeholders
Build capacity in knowledge, skills and capabilities of health providers, community members, government and policy makers
Implement the optimum package of SRH interventions and services in the four study sites
Evaluate feasibility, acceptability, client satisfaction, care seeking behaviour, service utilization, quality of care and some SRH outcomes
Evaluate cost and determinants of sustainability
Promote participation and involvement of local and national health authorities and policymakers
Disseminate  key results locally, nationally and internationally

 

More women, both from the general population and FSW, make better use of the different SRH services that will be offered at the different health services;
The quality of SRH services is improved;
Both clients and providers are satisfied with the services;
The costs of the SRH services are reasonable, in relation to the effects, and sustainable.