Using the Disca Tool

More documents

Recommendations

Info

• 70.5% examined and treated women for STI other than syphilis • Only two clinics did not refer pregnant STI clients for treatment. Three clinics referred first trimester cases and two referred women with genital warts. STI drugs and treatment This section looks at the availability of drugs Drug Out of stock at the time of DISCA assessment Out of stock in the month prior to Disca assessment Ciprofloxacin 0% 59% Metronidazole 18% 35% Erythromycin 82% 64% Doxycyline 53% 59% Benzathine 0% 6% • Drugs shortage, especially erythromycin and Doxycyline is a serious issue in this district. Reasons cited for this shortage were bad roads, which made it impossible for transport delivering drugs to reach the clinics. Insufficient supply was also another reasons. Staff training • The total number of Professional Nurses was 35, an average 2 per clinic. • Of the total number, 37% had been on formal training in STI Management and only 5.7% had received training in HIV Counseling. There is a big need for staff to be trained on STI Management and HIV Counseling Findings in Umzimkhulu Health District Of the 24 questionnaires that were given out, 18 were returned. The following findings are based on the 18 questionnaires that were returned. Accessibility • All the clinics are open at all times between 8-4pm • Sixty one (61%) of the clinics do not open after hours. Of all the districts in region E, this is the district with the highest number of clinics not opening after hours. • The total number of consultation rooms was 30. The range was 0-7 and the average 1.7 • Eighty three (83%) of the clinics use all rooms for STI consultation and in 77% of the consultation rooms STI patients are treated in private • The total number of adult patients was 20914 with a range of 369-2684 and the average of 1161 • The total number of STI clients was 754, which is 3.6% of the adult patients. The STI patients range from 11-156 with an average of 42.4 Seventeen clinics responded. Examination facilities • Only 88.9% clinics had examination couches. 12
• Only 44.4% clinics had examination lights. This is a very worrying factor because it then has a negative effect on the way women are diagnosed. • Only 66% clinics had sterilized specula. • The method used for sterilizing specula is boiling. Five clinics did not respond to this question. This could indicate that the question was not understood. This again, proves a great need for training in the DISCA tool or they don’t have or use specula. • All the clinics had examination gloves Provision of safe treatment • 94% of the clinics had STI guidelines, and all of them had these guidelines in all the consultation rooms • Only 66% of the clinics had individual education material. • Only 39% of the clinics had the education material in a local language. Again, they are missing out on clients who may not understand English. • Only four clinics had syphilis testing done on site. • The time taken for the results to come back from the laboratory ranging from one hour to a month. • 44% of the clinics have had male condoms running out in the past month. This is a worrying development in the wake of HIV/AIDS • 44% of the clinics had Partner Notification cards in adult consultation rooms. This was a very low percentage. With STIs, it is quite important that partners get treated as well to avoid re-infection. It would be interesting to find out if clients are told to bring their partners to the clinic as well. • Only 4 clinics take RPR blood from all STI clients and those that do not do this, take blood only for the following cases: • Relapses • Genital sores • Suspected syphilis • Clients that are not responding to treatment Treatment of STI clients • 67 (8,75%) of all the STI patients treated was vaginal discharge. • Only 2 clients presented with multiple STIs • The percentage of clients correctly treated was only 16%. The same reasons as in Mount Frere apply here Antenatal Screening and STD Treatment • Only 56% of the clinics reported doing syphilis testing on all pregnant women attending ANC for the first time. • 89% examined and treated women for STI other than syphilis • Only two clinics did not refer pregnant STI clients for treatment. Most clinics (47%) referred clients with genital warts. 13
Page 1 and 2: The Quality of Care for Sexually Tr
Page 3 and 4: FINDINGS AND INTERPRETATION .......
Page 5 and 6: In addition, the ISDS nurse trainin
Page 7 and 8: • It is worrying to note that not
Page 9 and 10: Examination facilities This looked
Page 11: • Sixteen clinics responded. The
Page 15 and 16: TABLES AND GRAPHS COMPARING THE FOU
Page 17 and 18: Flagstaaf's STI clients treatment M
Page 19 and 20: PERCENTAGE OF SPECIFIC STIs 16.00%
Page 21: GENERAL COMMENTS COMMENTS MT FRERE
Page 24 and 25: All the districts recommended the f

Using the Disca Tool

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?