The delivery and quality of sexually transmitted infections treatment by private general practitioners in Windhoek Namibia

Abstract

Introduction: The main objective for this study was to investigate the quality of Sexually Transmitted Infections (STI) treatment and control by the private sector in Namibia.

Method: This was a cross-sectional study employing quantitative methodology using different methods of data collection. A self-administered questionnaire exploring General Practitioners (GPs) perceptions of factors that influence the way they manage Sexually Transmitted Infections (STI) which was then concluded with the face to face interviews and the checklist that was used while doing observations in the consulting rooms.

Results: A total of 50 private general practitioners in the area of Windhoek were interviewed, 48 self-administered questionnaires plus all checklists were received back from the private general practitioners. None of the private general practitioners interviewed had specific training in the syndromic management of the STIs. The 86% of all patients were seen by these private general practitioners on a medical aid, while 14 % pay cash for service provided. With regard to Urethral Discharge, an average of 56.5% of GPs could treat urethral discharge correctly as per the Namibian syndromic approach guidelines. None of the GPs could demonstrate the correct treatment of genital ulcer (whether they received medical aid or not) as recommended in the syndromic approach guidelines in Namibia (GRN, 1999; 2000). Only 28% of the GPs could demonstrate the correct treatment of Pelvic Inflammatory Disease (PID) as per the syndromic management of the STIs. For patients without medical aid the drugs prescribed and their dosages for PID are correct but the frequencies are not in line with the guidelines as for patients with medical aid.

Discussion: In general, patients presenting with STIs to the GPs in private practices are not given quality of care because not all private general practitioners have time to do investigations, counseling, give condoms and to notify the partners of those with urethral discharge, genital ulcers and PID looking for treatment.

Figure 1

Correlation between number of CME sessions attended and years of qualification

Figure 2

Treatment of Pelvic Infection Drugs like Flagyl, Ciprobay and Doxycycline remain the most favourite choice of treatment for both patients with and without medical aid.

Figure 3

Comparison of management of female patients with and without medical aid presenting with pelvic inflammatory disease for the first time

Figure 4

Items possessed by doctors

Figure 5

Specific protocol used in the management of STI

Figure 6

Testsdone on women for ante natal care Only three private general practitioners do not do any tests on women who come for ANC care.