Syndromic management of sexually transmitted infections among pregnant women attending Nairobi city council clinics
Songwa, Alice Nangekhe
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Syndromic management (SM) is a World Health Organization (WHO) strategy for the management of Sexually Transmitted Infections (STI). Diagnosis is based on identification of syndromes, which are combinations of symptoms as reported, by client and signs observed during examination. The recommended treatments are effective for all possible causative agents that could cause the identified syndrome. Syndromic management is recommended for STI management in developing countries especially where laboratory facilities are unavailable. Although Syndromic Management has a wide application in developing countries, there are no systematic surveys to evaluate its performance in many of these countries including Kenya. This study was therefore designed to assess knowledge of STI attitude towards STI Management and health seeking behavior among pregnant women with STI. In, addition knowledge and attitude towards SM practice among health care providers (HCP) was assessed. In both cases, structured interview were used to collect data. Availability of Syndromic management drugs and materials was assessed using a checklist. In all, 414 women and 37 health care providers were recruited in the study. The knowledge of STI among pregnant women was generally poor but high on a few specific STI namely Syphilis (93.5%) Gonorrhea (90.5%) and HIV/AIDS (78.3%). The respondent's attitude towards the quality of STI management was below average (37.2%), although the patient perceived the quality to be high if the drugs were available (87.2%) or the health care providers were friendly (56.3%). On health seeking behaviour most respondents sought STI medical care (61.4%) but mainly from Public clinics (56.7%). Private clinics were sought by only 38.2%) with few patients treating themselves (4.7%) or seeking help from traditional herbalist (0.4%). The HCP had good knowledge of the indicators outlined in the WHO Syndromic management strategy. However, their attitude towards SM practice in Nairobi City Council clinics (NCC) was poor (16.7%), and was mainly moderated by the poor supply of drugs and availability of SM equipment and materials. In conclusion majority of the women had excellent knowledge of syphilis, gonorrhea and HIV/AIDS but had extremely poor knowledge of all other STI. Sexually transmitted infection management was perceived by the respondents as drug availability and staff friendliness. Although the Health Care Providers had good syndromic management knowledge, SM practice was harbored by availability of drugs and equipments. Health education campaign should target STI pregnant women. Drug and material supply should be encouraged to permit Syndromic Management practice among health care providers in Nairobi City Council Clinics. Taken together, these measure will facilitate STI control.
- MST-Zoological Sciences