Evaluating STI - Health Systems Trust

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– 9 – To what extent are speculum examinations done? Enter answer from 8 Most Most Most A few This answer is a subjective view obtained from clinicians at the clinic. However, it does give some insight into whether women with <strong>STI</strong>s are examined with a speculum. Clinics may record that most women are examined and yet they may not have any functioning lights. Are they recording what they think the answer should be? If most women are not examined, the reason for this needs to be investigated. Is it due to: ◆ ◆ ◆ ◆ ◆ ◆ Insufficient equipment (Even if there is insufficient equipment, it is not appropriate to assume that that is the only reason why more examinations are not done.) Lack of awareness that speculum examinations are part of comprehensive examination of women with <strong>STI</strong>s. Lack of confidence in carrying out speculum examinations. A perception that the clinic is too busy to have time to do speculum examinations. Lack of motivation about providing quality care. A combination of these factors? Current syndromic protocols in all consulting rooms? Enter answer from 9b Yes Yes Yes No Are individual client education materials available? Enter answer from 9c Yes Yes Yes Yes Are education materials in a local language? Enter answer from 9d Yes Yes No Yes If most of the clinics in an area have protocols in all consultation rooms and appropriate client education leaflets available, what is the reason why one or two clinics do not? It is important to recognise that availability of resources does not automatically mean effective use of these resources. Quality of care needs to be assessed on the actual management of clients and not just on the availability of all the necessary resources.
– 10 – Turn-around time for RPR results Enter answer from 11b 2-3 days 2 weeks 3 days 2 days Here too, it should be noted whether a delay in obtaining blood results is common to all the clinics in an area or only for one or two. In other words, is it a problem relating to a particular clinic, or is it a problem affecting the whole area? If most of the clinics have a turn around time of a week or more, further investigation is needed to find out the cause, and to explore ways of speeding up obtaining the results. Often the delay relates to transport problems. In this case is it possible for test results to be faxed to clinics? Condoms out of stock in last month? Enter answer from 12 No Yes No Yes With this question it is important to try and establish whether it has been answered correctly. In this case a ‘No’ answer means that there has been a constant supply of condoms. In the example above, 2 clinics recorded shortage of condoms and the other two had sufficient. Is this what they actually meant in their answers? Is there a problem with condom supply in the area? Are the clinics which run out of condoms more active in condom promotion than the others and therefore use more condoms than the neighbouring clinics? Is condom access both easy Check information in Easy and and private? answer 13 private Easy Easy Easy Where are condoms kept in this facility? Do clients have to get them from a clinician or can they easily help themselves? Are there places where they can help themselves without anyone else seeing – e.g. the toilets? Are they in all consultation rooms where clinicians can provide them and demonstrate how to use them if necessary? What impression does the answer to this question give about the attitude to condom promotion at this clinic? Is there a dildo available? Enter answer from 14b Yes Yes Yes Yes As is the case with education materials, the presence of a dildo does not necessarily mean effective and appropriate communication about condom use.
Page 2: Evaluating Quality of STI Managemen
Page 6 and 7: Purpose of this booklet This bookle
Page 8 and 9: DISCA analysis at a district level
Page 10 and 11: - 5 - SUMMARY OF DISCA RESULTS Clin
Page 12 and 13: - 7 - Why does one clinic not have
Page 16 and 17: - 11 - 3. STAFF WORKLOAD AND TRAINI
Page 18 and 19: - 13 - This page is taken from a co
Page 20 and 21: - 15 - 5. TREATMENT OF STI CLIENTS
Page 22 and 23: - 17 - Although most protocols do n
Page 24 and 25: - 19 - both these cases less cards
Page 26 and 27: - 21 - ◆ Three of the clinics wer
Page 28 and 29: - 23 - Key Step number 13 - Feedbac

Evaluating STI - Health Systems Trust

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