Integration of STD services. "All are part of the same service"
Jana, S.; Bailey, M.
Action Contre le Sida 25: 7
1995
PMID: 12291922 Document Number: 302637
Two projects have succeeded at integrating sexually transmitted disease (STD) services at the primary health care level. The first operates in Mwanza district in Tanzania. Nurses use the syndromic approach to diagnose STDs and prescribe treatment. They provide health education to STD patients while also distributing condoms and cards for partner contacts. Health workers attend a three-week seminar on diagnosing and treating the most common STDs. The first week is in a classroom. The remaining two weeks consist of practical training in a health center providing STD services. The project began at the main hospital in Mwanza and has since expanded to rural areas. Monthly supervisory visits to each health center ensure the drug supply. The project focuses on the symptoms of urethral infection, vaginal infection, and genital ulcers. Education programs and public awareness promote and popularize risk reduction sex behavior and improve utilization of health services. The other project (Sonagachi) serves sex workers and their clients in Calcutta, India. It integrates STD services with a primary health center. Since its inception in 1992, STDs have fallen and HIV prevalence has not changed. Sex workers involved in the Sonagachi project are more likely to use condoms with clients than those not involved in the project (50% vs. 20%). Community participation is the key to the success of the Sonagachi project. More than 65 former or current sex workers serve as peer educators. They have attended a six-week training program. They make home visits to sex workers to talk about sexual health, to distribute condoms, to show them how to use condoms, and to encourage them to attend the health center. Peer educators are proud of their work and say that their work gives them confidence and dignity. The peer educators with the most experience become peer educator trainers.