Evaluating STI - Health Systems Trust

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– 19 – both these cases less cards were issued than the number of clients seen. ◆ Clinic D has only one clinician trained in syndromic management. ◆ ◆ Only one clinic has partner notification cards written in a local language. Only one clinic has a functioning examination light in all consultation rooms. ◆ At clinic B only clients with urethral discharge received the correct drug treatment, and 3 out of 10 STI clients were diagnosed with PID. ◆ ◆ ◆ ◆ ◆ ◆ Two out of four clinics were short of condoms in the previous month. Only 1 clinic has condoms in an area where the client can take them without being observed. At two of the clinics only one person is trained in HIV counselling and at one clinic no clinicians have this training. Three of the clinics have problems with drug shortages. At only 1 clinic were all 10 clients given the correct drug treatment. Clinicians are not clear about the correct drug management during pregnancy, nor are they aware that Erythromycin can be used to treat chlamydia. Key Step number 12 – Write a Report This is a sample report on the 4 DISCAs entered in the summary sheets of the preceding pages. The list of strengths and weaknesses that was drawn up could be attached to the report. Where possible, use graphs, charts or tables to present the information as this usually conveys a clearer message than a written description. Even if you do not have access to a computer programme that will produce graphs, some of the graphs used here could easily be done by hand. Weaknesses at one particular clinic ◆ ◆ There seems to be a problem with record keeping at Clinic C. Clinic D does not have syndromic protocols or partner notification cards in all consultation rooms. Remember that a diagram or graph will usually convey a message more effectively than just a written sentence. ◆ At clinic B it takes 2 weeks to get RPR results.
Background Report on the quality of STI care at 4 clinics based on the DISCA During July quality of STI care was assessed at Clinics A, B, C and D using the District STI Quality of Care Assessment tool (DISCA). A meeting was held with the 4 facility managers at which the completion of the DISCAs was discussed. Opportunity was provided for the facility managers to ask any questions they had about the tool. Overall comment on the use of the DISCA ◆ All facility managers felt that the DISCA was a useful tool to assess quality of STI care. They were surprised to find how many aspects of STI management need improving as most of the staff felt that they were competent in managing clients with STIs. – 20 – ◆ ◆ ◆ ◆ Three of the clinics do not have suitable lighting in all consultation rooms to enable speculum examinations to be done effectively. Only two of the clinics keep a record of the number of partner notification cards issued or the number of partners treated. In both these clinics the number of cards issued was considerably less than the number of STI clients treated. (63% and 69%) Three of the clinics do not have partner notification cards written in a local language. The number of STI clients in relation to the total number of clients, as well as in relation to the number of clients seeking reproductive health services, is quite low. This is illustrated in Figure 1 and suggests that clients are only treated for an STI if that was the primary reason for attending the clinic. ◆ Despite the meeting before using the DISCA, it is apparent that more support needs to be given if good quality data is to be obtained. General comments ◆ Not all the information required by the DISCA was supplied.
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 14 and 15: - 9 - To what extent are speculum e
Page 16 and 17: - 11 - 3. STAFF WORKLOAD AND TRAINI
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Page 20 and 21: - 15 - 5. TREATMENT OF STI CLIENTS
Page 22 and 23: - 17 - Although most protocols do n
Page 26 and 27: - 21 - ◆ Three of the clinics wer
Page 28 and 29: - 23 - Key Step number 13 - Feedbac

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