Quality of health education during STD case management in Nairobi, Kenya

Quality of health education during STD case management in Nairobi was asses sed in 142 healthcare facilities, through interviews of 165 providers, obse rvation of 441 STD patients managed by these providers, and 165 visits of s imulated patients. For observations, scores were high for education on cont act treatment (74-80%) and compliance (83%), but unsatisfactory for counsel ling (52%) and condom promotion (20-41%). The World Health Organization (WH O) indicator for STD case management Prevention Indicator 7 (P17) (condom p romotion plus contact treatment) was poor (38%). Public clinics strengthene d for STD care generally performed best, whereas pharmacies and mission cli nics performed worst. Compared with observations, scores were higher during interviews and lower during simulated patient visits, indica ting that kno wledge was not fully translated into practice. Interventions to improve the presently unsatisfactory service quality would be wide distribution of hea lth education materials, ongoing training and supervision of providers, imp lementation of STD management checklists, and the introduction of pre-packa ged kits for STD management.