Syndromic management of sexually transmitted diseases in Botswana's primary health care: quality of care aspects
- 27 June 2003
- journal article
- Published by Wiley in Tropical Medicine & International Health
- Vol. 8 (7), 604-614
- https://doi.org/10.1046/j.1365-3156.2003.01076.x
Abstract
To evaluate the quality of care of the syndromic management of sexually transmitted diseases (STDs) in Botswana's primary health care. Participative observations of 224 consecutive consultations of patients with STDs (135 females and 89 males) by nurses. Twenty-one cases were excluded because no STD checklist was filled in. Criteria for acceptable history taking, physical examination and correct treatment were agreed upon. The quality of history taking and physical examination was acceptable for 25% and 23% of the women and for 54% and 57% of the men, respectively. Approximately, 65% of the women and 81% of the men received appropriate treatment. On average, consultations took 5.4 min for women and 4.6 min for men. STD contacts comprised 11% of STD cases. Advice on partner notification was provided to 66% of the women and 86% of men, and 75% and 89%, respectively, were counselled on the use of condoms. In half of the health facilities the lack of a fixed light source was the main constraint in carrying out a vaginal speculum examination. The availability of antibiotics and condoms was excellent. In 40% of the health facilities, all STD algorithms were displayed in the consultation room. One-third of women and one-fifth of men did not receive appropriate treatment for their STD, in spite of excellent provision of drugs. Although Botswana health workers perform relatively well on partner notification and counselling, there is considerable scope for improving the quality of medical history and clinical examination, especially in women. Emphasis should be given on training health workers in clinical examinations, in particular in pelvic examinations, and to supervision and in-service training.Keywords
This publication has 18 references indexed in Scilit:
- Adherence to treatment guidelines in primary health care facilities in BotswanaTropical Medicine & International Health, 2002
- Recent advances: Sexually transmitted infectionsBMJ, 2001
- Asymptomatic gonorrhoea and chlamydial infection in a population-based and work-site based sample of men in Kilimanjaro, TanzaniaInternational Journal of STD & AIDS, 2000
- Clinical management and prevention of sexually transmitted diseases: a review focusing on womenActa Tropica, 2000
- Partner notification in the United States: An evidence-based reviewAmerican Journal of Preventive Medicine, 1999
- Preventing HIV infection: lessons from Mwanza and RakaiThe Lancet, 1999
- Chemokine-receptor polymorphisms: clarity or confusion for HIV-1 prognosis?The Lancet, 1998
- Cost-effectiveness of improved treatment services for sexually transmitted diseases in preventing HIV-1 infection in Mwanza Region, TanzaniaThe Lancet, 1997
- HIV and Reproductive Tract Infections in a Total Village Population in Rural Kilimanjaro, TanzaniaJAIDS Journal of Acquired Immune Deficiency Syndromes, 1997
- Asymptomatic gonorrhoea and chlamydial infection in rural Tanzanian menBMJ, 1996