Quality of STD care in Zambia. Impact of training in STD management

Study objective: To assess quality of care of sexually transmitted diseases (STDs) and evaluate interactive training methods aimed at improving providers' performance. Design and setting: This comparative study, with a baseline, intervention, and evaluation phases was conducted at two urban health centers in Zambia. The personnel at one health center were trained in STD management using interactive training methods. The other health center acted as a control. Subjects and methods: Two-hundred patients with STD were interviewed and their interaction with health care providers observed before and after the training. Another 200 interviews and observations were conducted at the control health center. Results: The proportion of patients being examined, given health education and informed about partner notification increased significantly after the intervention. The proportion of patients who had complaints about the health care did not decrease. Long waiting time and lack of time to discuss the disease were the main complaints. Conclusion: The training solved some, but not all, problems of poor case management. This indicates the need for a more process-oriented approach for improving quality of care. (C) 1997 Elsevier Science Ltd.