Objectives: To evaluate the feasibility and impact of a health education intervention promoting partner notification for sexually transmitted diseases (STDs). Methods: The research setting was a busy public health clinic in a rural district in KwaZulu Natal, South Africa. A before/after quantitative study design was used to measure the effect of an audiovisual presentation of a compelling love drama, posters, and pamphlets. Measures collected from all consenting STD index patients during a 6 week pre-intervention (control) phase were compared with those collected during a 6 week intervention phase. A qualitative evaluation assessed whether the intervention accurately portrayed the intended educational messages. Results: 150 index patients (55% female) were interviewed in the control phase and 185 index patients (64% female) in the intervention phase. The intervention phase showed improvements on several measures of self efficacy about notifying casual partners, such as a belief among index patients that a greater proportion of their casual partners would see the importance of seeking treatment as a result of their notification interaction. The rate of contact cards returned per index patient was 0.27 in the intervention phase, compared with 0.20 in the control phase (95% CI for the rate difference: −0.05, 0.17). The qualitative research found that the intervention was thoroughly enjoyed by patients and clinicians, but a fundamental problem with it was that patients received confused messages about the relation between HIV/AIDS and other STDs. This has potentially negative consequences for partner notification. Conclusion: The intervention needs further development, and then could provide a highly acceptable, cost effective model for health education in clinics in developing countries.
The quality-assessment instrument proved easy to use, can be adapted to local requirements and is appropriate for use in developing countries. The authors maintain that using this instrument in various district clinics could help supervisors identify the main impediments to the delivery of high quality services, and give them a platform from which to set priorities in training, infrastructure, equipment and supplies.
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