QUALITY OF STD CARE IN ZAMBIA - IMPACT OF TRAINING IN STD MANAGEMENT

Study objective: To assess quality of care of sexually transmitted dis eases (STDs) and evaluate interactive training methods aimed at improv ing providers' performance. Design and setting: This comparative study , with a baseline, intervention, and evaluation phases was conducted a t two urban health centers in Zambia. The personnel at one health cent er 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 c enter. Results: The proportion of patients being examined, given healt h education and informed about partner notification increased signific antly after the intervention. The proportion of patients who had compl aints about the health care did not decrease. Long waiting time and la ck of time to discuss the disease were the main complaints. Conclusion : The training solved some, but not all, problems of poor case managem ent. This indicates the need for a more process-oriented approach for improving quality of care. (C) 1997 Elsevier Science Ltd.