Lesson learnt in the implementation of PHC - Health Systems Trust

The Use of the District Quality of Care (DISCA)
Tool in Mopani District, Limpopo
3 Quality
of Care
LESSONS LEARNT
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Training does not automatically transfer to good practice. Most professional
nurses were trained in syndromic management, yet many clients were still
incorrectly treated. This demonstrated the need for continuous in-service
training and mentoring.
The evaluation demonstrated that lack of supervision was one of the main
contributing factors in the lack of equipment. In most cases the supervisors
were not aware of the lack of protocols, dildos, condoms, and examination
equipment such as the specula.
The shortages of STI drugs indicated that there was a need to develop drug
control mechanisms and to improve communication between the pharmacy
and clinic staff.
Clinic managers and local area supervisors must ensure the use of STI
protocols and guidelines.
There is the general assumption that each STI client has only one sexual
partner, which is not always the case. Thus there is a tendency to give an
STI client only one partner notification card, with possible missed
opportunities and potential re-infections. This is caused by poor history
taking and staff attitude towards clients.
The DISCA was very useful for:
– Identifying current quality of STI care at health facilities.
– Identifying factors that contribute to providing a good service.
– Identifying problems affecting quality of STI care.
– Helping the district develop an action plan to improve and monitor
the quality of STIs.
Recommendation
Every clinic needs a regular (monthly) written report about supervision
and support given to that clinic. This report should be filed with the clinic
and sub-district management team.
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