No abstract

Objective:In 2004, the Ministry of Health adopted revised protocols for the syndromic management of sexually transmitted infections (STI) that included routine HIV testing. A training programme for providers was developed on the revised protocols that featured interactive case studies and training videos. An objective of the first phase of the training programme was to test its effect on four measures of clinical practice: (1) routine HIV testing; (2) performance of physical examination; (3) risk-reduction counselling and (4) patient education.Methods:Clinical practice in a district where providers were trained was compared with a district without training. The measures of clinical practice were reported by 185 patients of providers who had been trained and compared with reports by 124 patients at comparison clinics.Results:Relative to patients at comparison clinics, a higher percentage of patients of trainees reported that the provider: (1) offered an HIV test (87% versus 29%; p<0.001); (2) conducted a physical examination (98% versus 64%; p<0.001); (3) helped them to make a plan to avoid future STI acquisition (95% versus 76%; p<0.001) and (4) provided patient-specific information about HIV risk (65% versus 32%; p<0.001). Among patients offered HIV testing, the percentage who accepted did not differ between groups (38% of 161 patients of trainees versus 50% of 36 comparison patients; p = 0.260). Overall, 33% of patients of trainees and 14% of comparison patients were tested (p<0.001).Conclusion:A multifaceted training programme was associated with higher rates of HIV testing, physical examination, risk-reduction counselling and better HIV risk education.

The coronavirus disease 2019 has led to an unprecedented global public health crisis. COVID-19 was declared a Public Health Emergency of International Concern on January 30, 2020 and a pandemic on March 11, 2020 by the World Health Organisation (WHO). Following the COVID-19 outbreak, WHO and other public health organisations developed preventive guidelines against the disease. Using desktop research, this paper looks at current COVID-19 preventive measures and highlights some lessons for mandatory public health policy measures. The paper begins by giving a brief account on the background to coronavirus disease 2019, its modes of transmission, as well as current preventive measures against the disease. The paper concludes by recommending mandatory public health policy measures that need to be adopted to prevent, control and manage current and future similar outbreaks. In particular, considering the current COVID-19 preventative measures, the paper advances some recommendations on priority areas that could be adopted, maintained and sustained at policy level to provide direction on prevention and control of transmissible diseases. The priority areas recommended include but not limited to, risk assessment, community education, social and physical distancing strategic interventions, disinfection measures as well as the provision of Personal Protective Equipment (PPE).