APPROACHES TO CONTROL SEXUALLY-TRANSMITTED DISEASES IN HAITI, 1992-95

Despite major obstacles, activities to control sexually transmitted di seases (STDs) were initiated in Haiti in 1992 in collaboration with lo cal nongovernmental organizations. The approaches included review of a vailable local data, assessment of STD case management practices and c onstraints, and development of specific STD control activities at the primary health care level, such as systematic screening of all pregnan t women for syphilis and improved comprehensive syndrome-based STD cas e management The activities included conduct of local studies, present ation and dissemination of results to key audiences, training of healt h care providers, improvement of local capacities, and consensus-build ing on implementation of STD control approaches. STD awareness and cas e management improved considerably; for example, 69% of the clinicians interviewed reported correct STD treatments in the north-eastern prim ary health care centres in 1995, compared with <10% in 1992. At the en d of the project, national STD case management guidelines were develop ed by consensus between the various organizations and the Ministry of Health. Lessons learned included the importance of local data generati on and of communication and collaboration with various institutions fo r consensus-building, the need for continued training, and field super vision to ensure behaviour change among STD care providers, A national STD control programme should be implemented as soon as possible in bo th the public and private sector. External funding will remain critica l to control this important public health problem in Haiti.