Health providers' competence in the management of reproductive tract infections in Vientiane, Lao People's Democratic Republic

Sihavong, Amphoy; Lundborg, Cecilia Stålsby; Syhakhang, Lamphone; Vernby, Åsa; Panyanouvong, Amphayvanh; Marions, Lena; Wahlström, Rolf

doi:10.1258/095646207782212270

Cited by 11 publications

(11 citation statements)

References 19 publications

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“…Another study from Laos found that drugs obtained from pharmacies often have limited efficacy in curing STIs [23]. Moreover, pharmacists/drug sellers have been found to have inadequate knowledge and competence in the management of STI [8,10]. STI training for STI service delivery staff from both the public and the private health sectors is needed.…”

Section: Discussionmentioning

confidence: 99%

“…In a study from Laos, HCPs, especially in rural areas, reported inadequate knowledge and competencies regarding management of reproductive tract infections (RTIs), including STIs [8]. Owing to the lack of STI clinics and clinical STI specialists, patients with STIs are mainly seen by gynecologists or general health practitioners, often with low competencies in STI management [8]. In addition, self-medication for RTIs including STIs through private pharmacies is common among FSWs in Laos [7].…”

Section: Introductionmentioning

confidence: 99%

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Care seeking behaviour and barriers to accessing services for sexually transmitted infections among female sex workers in Laos: a cross-sectional study

Phrasisombath

Thomsen

Sychareun

et al. 2012

BMC Health Serv Res

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BackgroundPrompt, correct diagnosis and treatment with health information are essential components of reproductive tract infection (RTI) and sexually transmitted infection (STI) services. This study aims to describe care seeking behaviour and barriers to accessing RTI/STI services among female sex workers (FSWs) in Laos.MethodsA cross-sectional survey using closed and open-ended questions was performed in six districts along Road 9, traversing Savannakhet province from Thailand to Vietnam. In total, 407 FSWs were interviewed. The data were analyzed and presented descriptively. Multiple logistic regression analysis was applied to assess associations between respondents' background characteristics and care seeking behaviour.ResultsAbout half of the respondents (49%) were less than or equal to 19 years of age, and 50% had started or completed secondary school. Fifty-eight percent had been engaged in sex work for less than 1 year. Eighty-six percent of the respondents reported RTI/STI signs or symptoms currently or in the last 3 months but only two-thirds of those with symptoms sought treatment. Source of treatment for the last RTI/STI episode was the drop-in centre (53%) followed by a public hospital (23%), private clinic (12%), private pharmacy (9%), and herbalist (2%). The main barriers to service use were long waiting time, inconvenient location of the clinic, not knowing where to get the services needed, and negative attitudes among healthcare providers. Care seeking behaviour was associated with longer duration of sex work (OR = 2.6, 95%CI 1.52-5.36). Forty-four percent received health information from peer educators, 34% from fellow friends, 26% from a pimp, and 26% had received information from a healthcare provider during the visit.ConclusionThere were several barriers to accessing RTI/STI services and they were related to both structural and individual factors. Innovative STI service strategies to inform FSWs about the importance of early diagnosis and treatment should be established. Continuous training for STI service providers focusing on counseling skills and awareness of the sexual health care needs for FSWs is recommended in order to minimize the barriers experienced by FSWs in this particular setting.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Care seeking behaviour and barriers to accessing services for sexually transmitted infections among female sex workers in Laos: a cross-sectional study

Phrasisombath

Thomsen

Sychareun

et al. 2012

BMC Health Serv Res

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“…The final practice competence score as well as knowledge score was then divided into three groups, optimal (≥ 75% of total score), medium (50–74% of total score) and suboptimal (< 50% of total score). These limits have been used as cut-off points in previous studies about knowledge among health personnel [ 20 , 21 ]. A fourth group, very low (< 25%), was later added to distinguish the knowledge level within the suboptimal group.…”

Section: Methodsmentioning

confidence: 99%

Management of noma: practice competence and knowledge among healthcare workers in a rural district of Zambia

Ahlgren

Funk

Marimo

et al. 2017

Global Health Action

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Background: Noma is an infectious but opportunistic disease that often results in severe facial disfigurements and mortality if untreated. As noma progresses quickly, early detection and treatment are important to prevent its development.Objectives: The objective of this study was to investigate primary healthcare workers’ knowledge and management of noma in a rural part of Zambia.Methods: A cross-sectional self-completed survey was conducted among 35 healthcare workers from two district hospitals and 15 rural health centres in Serenje District, Zambia. Participants’ practice competences and knowledge were grouped into ‘optimal’, ‘medium’, ‘suboptimal’ and ‘very low’.Results: Most of the healthcare workers stated that they perform mouth examination of a child below five years of age who is suffering from measles, malnutrition or HIV. A majority diagnosed gingivitis correctly and 40% had a medium level of practice competence of the same noma stage. All participants had a suboptimal or very low level on overall practice competence regarding management of noma and two-thirds had a very low level of reported knowledge.Conclusion: General knowledge on noma and competences of diagnosing and treating noma patients was low among healthcare workers. Lack of knowledge could present a barrier for correctly managing noma at an early stage. Improving knowledge among healthcare workers is one way to prevent the development of the disease. In order to prevent noma from the start, actions need to be focussed on improving (oral) hygiene and health education as well. Telemedicine could also be considered as it can help healthcare workers in handling noma patients through enabling communication and exchange of information with specialist.

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“…Improved case management of STI has been scientifically proven to reduce the incidence of HIV infection in the general population [ 3 ],[ 4 ]. In low-income countries, STI management is usually inadequate [ 5 ]-[ 7 ] and STI control programmes often fail for various reasons [ 8 ]. It has been shown that healthcare providers (HCPs) play an important role in reducing the burden of STI through effective prevention and management [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Improved knowledge and reported practice regarding sexually transmitted infections among healthcare providers in rural Vietnam: a cluster randomised controlled educational intervention

et al. 2014

Self Cite

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BackgroundHealthcare providers (HCPs) play a critical role in controlling the spread of sexually transmitted infections (STI) through early and accurate diagnosis, appropriate treatment and prevention counselling. This study aimed to assess the effectiveness of an educational intervention about STI on knowledge and reported practice among HCPs and to explore which determinants may influence the intervention’s effects.MethodsA cluster randomized controlled educational intervention was carried out in a rural district, Vietnam. 32 communes of the district were randomized into two arms, with 160 HCPs in an STI intervention arm and 144 in a control arm. The STI intervention comprised interactive training with basic STI knowledge, case scenarios, and poster distribution. Questionnaires to evaluate knowledge and reported practice were completed three times: before, during and after the intervention. Correct answer was scored as 1; “do not know”, incorrect answer was scored as 0. Univariate and multilevel multivariate analyses were applied.ResultsOf the maximum 56 points, the mean knowledge score increased significantly in the STI intervention arm and in the control arm post-intervention (37.2 to 48.4, and 32.7 to 41.7, respectively). In multivariate regression analysis, knowledge improvement in the intervention arm was significantly higher than that in the control arm (regression coefficient = 2.97, p = 0.008). Other factors which positively influenced the increase in knowledge were being between 35 and 50 years old, having intermediate professional training, being a pharmacist or working at a village level (regression coefficient: 2.81, 4.43, 5.53 and 7.91, respectively). Post-intervention, the mean reported practice score increased significantly in the STI intervention arm (from 17.6 to 21.8) and insignificantly in the control arm (maximum 36 points). Factors which positively influenced the increase in reported practice were being between 35 and 50 years old, having intermediate professional training, or working at a pharmacy/drugstore (regression coefficient: 2.15, 3.33 and 3.22, respectively).ConclusionsThis study indicates that an educational intervention including interactive training and multi-faceted interventions may be effective in improving STI knowledge and reported practice of HCPs at grassroots level, particularly among pharmacists, HCPs who work in villages or pharmacies/drugstores, and who initially have low STI knowledge.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-014-0646-5) contains supplementary material, which is available to authorized users.

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Health providers' competence in the management of reproductive tract infections in Vientiane, Lao People's Democratic Republic

Cited by 11 publications

References 19 publications

Care seeking behaviour and barriers to accessing services for sexually transmitted infections among female sex workers in Laos: a cross-sectional study

Care seeking behaviour and barriers to accessing services for sexually transmitted infections among female sex workers in Laos: a cross-sectional study

Management of noma: practice competence and knowledge among healthcare workers in a rural district of Zambia

Improved knowledge and reported practice regarding sexually transmitted infections among healthcare providers in rural Vietnam: a cluster randomised controlled educational intervention

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