Simulated patients ratings of sexually transmitted disease care in primary health care clinics

Abstract

is a major health concern internationally and nationally. The sub-Saharan region. South Africa in particular, has some of the highest prevalence rates in the world. This region is also one of the least economically developed regions, and in addition to the HIV/AIDS epidemic it is faced with the challenge of developing the economy for the citizens while maintaining high social services standards. Available literature suggests that the link between STDs and the spread of HIV. and the economic status of most developing countries influenced the world health organization's decision to recommend the syndromic case management approach to STD care. Moreover, literature evaluating the quality of STD care indicates that poor communication, counselling and history taking skills, long waiting periods and lack of support for staff contribute to poor quality of care. This study aimed at evaluating the quality of care that sexually transmitted disease patients receive at primary health care clinics from a simulated patients' perspective. Four post-graduate students, two of whom were females and the other two males, visited 24 clinics. After each visit they each completed a semi-structured questionnaire and recorded their experiences in a journal. Results indicate that health care providers are competent in some aspects of service provision, for example with regard to diagnosis and offering appropriate medical treatment. Other aspects of the service that were seen as influencing service provision included poor counselling, condom education and partner notification. It was recommended that future research should evaluate the impact of factors such as motivation and time management skills of health care providers on service provision. Further recommendations included- the possibility of offering continuous support and training to health care providers.