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    Peer Reviewed

    Indicators and the measurement of STD case management in developing countries.

    Saidel TJ; Vuylsteke B; Steen R; Niang NS; Behets F; Khattabi H; Manhart L; Brathwaite A; Hoffman IF; Dallabetta G

    AIDS. 1998; 12 Suppl 2:S57-65.

    The World Health Organization's Global Program on AIDS (WHO/GPA) has developed a protocol for conducting facility-based assessments of sexually transmitted disease (STD) case management strategies. The WHO/GPA methodology measures two composite prevention indicators (PIs): PI16--the proportion of patients presenting with STD symptoms who are diagnosed and treated appropriately, and PI17--the proportion who receive basic counseling about condoms and partner notification. The protocol calls for direct observation of provider-client interactions and provider interviews. This article reviews the research literature on the evaluation of STD case management in developing countries. Several studies adapted the WHO/GPA protocol for resource-poor settings and utilized techniques such as record review, patient encounter forms, patient exit interviews, and simulated patients and pharmacy shoppers. Overall, experience indicates that it is difficult to implement the protocol as intended in all field situations. Although nonstandardized alternative methods of data collection do not provide a composite PI16 score, they do generate rich data for monitoring the quality of STD case management and contribute to managerial and supervisory aspects of intervention programs. A widespread observation was that providers have the knowledge to provide better quality STD care than they do in actual practice.
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