CASE-MANAGEMENT AND PATIENT REACTIONS - A STUDY OF STD CARE IN A PROVINCE IN ZAMBIA

Sexually transmitted disease (STD) case management was evaluated throu gh observation and interviews at 2 urban and 4 rural health centres an d 2 district hospital STD clinics in one urban and 2 rural districts i n Central Province, Zambia. The analysis was limited to 59 patients (4 2 men and 17 women) who paid first visits for their disease and were m anaged by a clinical officer. The evaluation suffered from the lack of a standard for case management. Results showed that the patients enga ged in risky sexual behaviour without being aware of the risks. At the health institutions, few patients were informed about condoms, the ri sk of HIV, and abstinence from sex during treatment and few were asked to notify their partners. Clinical officers with special STD training performed better than others but sill informed only one-fifth of the patients. Few clinical officers managed patients according to the synd romic approach recommended by the STD control programme.