Evaluating STI - Health Systems Trust

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– 21 – ◆ Three of the clinics were out of stock of at least one drug in the previous month. The following table illustrates the availability of drugs in the four clinics. Figure 4 shows the number of clients treated for each syndrome and the number that were correctly treated. Figure 3 indicates the number of episodes of each syndrome amongst the 40 clients recorded. Knowledge of correct treatments Clinicians knew the correct treatment for urethral and vaginal discharge at all 4 clinics. At one clinic the treatment stated for genital ulcers was incorrect, and at two clinics incorrect treatment was stated both for STIs in pregnancy and the correct alternative to Doxycycline.
– 22 – Additional Comments The following points would not need to be included in the report, but are given here in order to give a fuller comment on the information from the 4 DISCAs. This provides a guide for identifying issues that are reflected in the completed DISCA forms. Comments on Specific Clinics Clinic A Clinic B ◆ ◆ ◆ ◆ ◆ Although the total number of clients is not recorded, from the other figures, this clinic seems to have the best client/provider ratio out of the 3 clinics that gave client figures. Not all staff are clear about the correct drug treatments. The turn around time for RPR results is exceptionally long, considering that the other 3 clinics in the area receive them within a few days. This is also obviously quite a big and busy clinic. Condoms were out of stock during the previous month. Despite the fact that all clinicians have undergone training both in syndromic management and HIV counselling, only 3 out of the 10 clients were correctly treated. However, those clinicians who were asked about treatment, knew the correct drugs (apart from in pregnancy), so the problem may have been the unavailability of drugs. Clinic C Clinic D ◆ ◆ ◆ ◆ ◆ ◆ ◆ ◆ ◆ ◆ This clinic has more drugs out of stock than any of the others, which suggests that part of the problem may be at the clinic level. Three out of 10 clients with PID suggests that clients with vaginal discharges may not be seeking treatment, and that clinicians may not be screening for STIs among clients who come for other reasons. Record keeping at this clinic appears to be poor. On the other hand, this is the only clinic that does not report having drug shortages. Very few clients at this clinic are treated for STIs, despite having quite high numbers of family planning clients. Few women with STIs are examined with a speculum. This may be because only one consultation room has an examination light. Although the syndromic guidelines are not in all consultation rooms, correct treatment was given to all 10 clients apart from one (Warts or other STI). Partner notification cards are not in all consultation rooms. Only 1 clinician has been trained in syndromic management and none in HIV counselling. This clinic appears to be male friendly as at least 6 out of the 10 clients recorded were men.
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
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 28 and 29: - 23 - Key Step number 13 - Feedbac

Evaluating STI - Health Systems Trust

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