| Summary: | Nurses in Malawi are in the forefront of service provision for HIV prevention and family planning. However, not much is known about how nurses actually practice the integration of family planning and HIV prevention services as prescribed by the President's Emergency Plan for AIDS Relief in Malawi. There is recognition that integration of HIV and reproductive health service delivery is needed to support women's and men's reproductive health needs, and to push the HIV epidemic back, with the goal of achieving an HIV-free generation and to meet several of the Millennium Development Goals (UNAIDS, 2010:21). The purpose of the study is to explore and describe nurses' practice in the integration of family planning and HIV prevention services in Ntcheu district, Malawi. The research question was 'How do nurses' practice the integration of family planning and HIV prevention services in Malawi, Ntcheu district?'. Use was made of Cabana et al.'s (1999) modified model of assessing facilitators and barriers to knowledge use as the theoretical framework that guided the study. A descriptive qualitative case study design was deemed appropriate to answer the research question. Semi-structured interviews and field notes were used to collect data. The sample consisted of 10 nurses who had undergone training in both family planning and HIV prevention services. Purposive sampling techniques were used for selection of participants. The five steps for carrying out interpretative content analysis outlined by Blanche, Durrheim and Painter (2006) were used. These include familiarisation and immersion, coding, induction of themes, elaboration, and interpretation and checking. This yielded eight themes related to family planning and HIV prevention integration practice, namely: facilitation of access and acceptability of comprehensive integration of family planning and HIV prevention services; educating and counselling clients; early detection of HIV among women of childbearing age; personal and professional benefits of integrating family planning and HIV prevention services (positive attitude); resentment of integration of family planning and HIV prevention services (negative attitude); policy-related barriers; human resource-related barriers; and competence-related barriers. The nurses at Ntcheu District Hospital, Malawi, practice the integration of HIV and family planning services effectively according to integration of family planning and HIV prevention guidelines, despite challenges such as inadequate human resources and lack of policies and guidelines at the clinic. It is therefore recommended that Ntcheu hospital management team adopts and implements task shifting of certain nursing duties to volunteers, in order to promote integration of family planning and HIV prevention services. This recommendation is based on the example of Tanzania, where Pathfinder International worked with district health management teams and health facility staff to recruit and train a volunteer cadre that initially provided only home-based HIV care and testing services (Banzi et al., 2011). It is therefore recommended that refresher courses and mentorship programmes be developed and implemented in order to improve nurses' competencies in the integration of family planning and HIV prevention services in Ntcheu district, Malawi. A large-scale quantitative study is recommended in order to generate data that will be representative of all family planning clinics in Malawi.
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