Improving quality of sexually transmitted disease case management in rural South Africa.
To measure quality of sexually transmitted disease (STD) syndromic case management and aspects of health-seeking behaviour at baseline in an intervention trial.
Ten rural primary care clinics, Hlabisa district, South Africa.
Simulated patients (fieldworkers trained to present with STD syndromes) made a total of 44 clinic visits ; 49 STD patients were interviewed when exiting clinics ; facilities were assessed for availability of necessary equipment and drugs ; 10 focus group discussions were held with staff ; and STD syndrome surveillance was performed in all 10 clinics.
A total of 9% of simulated patients were correctly managed (given correct drugs, plus condoms and partner notification cards), recommended drug treatment was given in only 41% of visits, and appropriate counselling was given in 48% of visits.
Among patients leaving the clinic, although 39% waited over an hour to be seen and only 37% were consulted in private, all reported staff attitudes as satisfactory or good.
Only six clinics had syndromic management protocols available, three reported intermittent drug shortages, and seven lacked partner notification cards.
Focus group discussions revealed good staff knowledge about STD, but showed lack of training in syndromic management and low morale. (...)
Mots-clés Pascal : Maladie sexuellement transmissible, Contrôle qualité, Soin, Zone rurale, Homme, Prévalence, Afrique, République Sud Africaine, SIDA, Virose, Infection, Education santé, Personnel sanitaire, Immunopathologie, Immunodéficit
Mots-clés Pascal anglais : Sexually transmitted disease, Quality control, Care, Rural area, Human, Prevalence, Africa, South Africa(Republic), AIDS, Viral disease, Infection, Health education, Health staff, Immunopathology, Immune deficiency
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0034421
Code Inist : 002B05A02. Création : 31/05/1999.