This study used a
quasi-experimental pre-post design to test whether short training can improve
medicine sellers' (MSs) practices and skills for prevention and control of
sexually transmitted infections (STIs) in Bangladesh. The training included
lectures, printed materials, and identification of referral sites.
Difference-in-differences estimation was used to determine the effects of
intervention on key primary and secondary outcomes. Advice given by the MSs in
intervention group for partner treatment and condoms use increased
significantly by 11% and 9%, respectively, after adjusting for baseline
differences in education, religion, age, duration of training, and study site.
Referral of clients to qualified service providers increased by 5% in the
intervention group compared to the comparison group, but this change was not
found to be statistically significant. Significantly higher proportion of MSs
in the intervention group recognized the recommended medications as per the
national syndromic management guidelines in Bangladesh for treatment of
urethral discharge and genital ulcer symptoms. Short training intervention was
found to be effective in improving MSs' practice of promoting condom use and
partner treatment to the clients. We anticipate the need for broad based
training programs of MSs to improve their skills for the prevention and control
of STI/HIV in Bangladesh.
Below: Proportion of medicine sellers who recognized antibiotics as
per national syndromic management guideline for selected symptoms of sexually
transmitted infections. DiD∗: difference in
differences.
Table 2
Practices of medicine sellers to the clients with symptoms suggesting sexually transmitted infections.
| Characteristics | Baseline | End line | ||
|---|---|---|---|---|
| N (%) unless otherwise specified | Comparison | Intervention | Comparison | Intervention |
| (n = 118) | (n = 151) | (n = 116) | (n = 138) | |
| Patients with STI symptoms seen in the last month (median, range) | ||||
| Male patients | 4 (0–30) | 5.0 (0–85) | 6 (0–60) | 7 (0–38) |
| Female patients | 2.5 (0–30) | 3 (0–50) | 3.0 (0–25) | 4 (0–22) |
| Method of STIs assessment in men∗ | ||||
| History only | 82 (69.5) | 132 (87.4) | 68 (58.6) | 85 (61.6) |
| History and physical exam. | 34 (28.8) | 15 (9.9) | 46 (39.7) | 49 (35.5) |
| History and laboratory investigations | 7 (5.9) | 6 (4.0) | 11 (9.5) | 6 (4.3) |
| Method of STIs assessment in women∗ | ||||
| History only | 88 (74.6) | 110 (72.9) | 110 (94.8) | 123 (89.1) |
| History and physical exam | 3 (2.5) | 0 | 11 (9.5) | 8 (5.8) |
| History and laboratory investigations | 30 (25.4) | 41 (27.1) | 5 (4.3) | 15 (10.9) |
| Given paper prescription to patients | ||||
| Always | 39 (33.1) | 23 (15.2) | 58 (50.0) | 58 (42.0) |
| Sometimes | 69 (58.5) | 108 (71.6) | 53 (45.7) | 77 (55.8) |
| Never | 10 (8.4) | 20 (13.2) | 5 (4.3) | 3 (2.2) |
| Got private space for physical examination | 43 (36.4) | 47 (31.1) | 50 (43.1) | 66 (47.8) |
| Received consultation fee from patients | 1 (0.8) | 13 (8.6) | 2 (1.7) | 12 (8.7) |
∗Multiple responses accepted.
Full article
at:
By:
1Global Health Unit, University of Montreal
Hospital Research Centre (CR-CHUM), Montreal, QC, Canada H2X 0A9
2School of Public Health, University of
Montreal, Montreal, QC, Canada H3N 1X9
3Centre for Reproductive Health,
International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b),
Dhaka 1212, Bangladesh
*Nazmul Alam: Email: ac.laertnomu@mala.lumzan
More at: https://twitter.com/hiv_insight
No comments:
Post a Comment