Voeten H, O'Hara H, Bwayo JJ, Habbema JD; International Conference on AIDS.
Int Conf AIDS. 2000 Jul 9-14; 13: abstract no. TuPeD3668.
H. Voeten, Erasmus University Rotterdam, POBox 1738, 3000 DR Rotterdam, Netherlands, Tel.: +311 040 877 14, Fax: +311 040 894 49, E-mail: voeten@mgz.fgg.eur.nl
Background: Since STDs contribute considerably to the burden of disease in developing countries and enhance the spread of HIV, this study was done to identify needs for training in STD care/other interventions. Methods: All identified facilities in 5 sampled sub-locations in Nairobi which treated 4 or more STD patients in the past week were studied. Providers were unexpectedly visited by one disguised simulated STD patient (complaint: discharge), and formal sector providers were observed during one working day and interviewed. Results: In total a pool of 192 formal sector providers were studied with either of the three methods (114 providers with all 3 methods); 138 providers were observed managing at least 1 STD patient (average 3.2). STD management by providers: Formal sector Inf. sector Interv. Observ. Simul. Simul., n = 165 n = 138 n = 165 n = 75 Correct history taking 89% 75% 62% 16% Correct examination 78% 44% 31% not applic. Correct treatment not applic. 44% 42% 0% PI6 (correct hist. taking/exam./trtmt.) not applic. 15% 13% 0% Ranking for observed correct treatment of patients in formal health care facilities was: special STD clinics 79% (n = 62 patients), government facilities strengthened for STD care 72% (n = 54), non-strengthened government facilities 68% (n = 19), NGO/community based facilities 60% (n = 42), mission/religious based facilities 54% (n = 103), private pharmacies 36% (n = 39), private clinics/dispensaries 31% (n = 115). Conclusions: There is a discrepancy between knowledge (Interview), performance (Observation) and daily practice (Simulation) in STD care in Nairobi; therefore supervision of daily care might be as important as training. Training is necessary in private facilities (high caseload but worst performance regarding treatment).
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Ambulatory Care Facilities
- Case Management
- HIV Infections
- Health Personnel
- Humans
- Interviews as Topic
- Kenya
- Patient Education as Topic
- Sexually Transmitted Diseases
- education
- methods
- therapy
Other ID:
UI: 102239724
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