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Health services and policy oral session 2—Evaluation of services and policies
O5-S2.03 Effect of improving the STI services in seven provinces of China
  1. X D Gong,
  2. J Jiang,
  3. X h Su,
  4. N X Cao,
  5. X L Yue
  1. Institute of Dermatology, Chinese Academy of Medical Sciences, National Center for STD Control, Nanjing, China

Abstract

Background The STI services can reduce HIV transmission and have been the important component of HIV control programmes. In China, the STI services remain weak. Under the framework of AIDS control programme of the Global Funds Round 4, we conducted the sub-programme to improve STI services in 21 counties of 7 provinces in China from 2007 to 2009, including one-week training workshops for all STI care providers, two-month field training for key STI clinicians at STD Clinic of National Center for STD Control, STI drug assurance, and quality services offering for STI patients. Annually the effect of STI services was assessed according to the guideline of WHO/UNAIDS in the 21 counties.

Methods The assessment of STI services was through health facility survey, including three indicators: (1)STI service indicator 1 (SI1) is defined as the per cent of patients with STIs at observed health care facilities who are appropriately diagnosed and treated according to the national guidelines on STI treatment in China; (2) STI service indicator 2 (SI2) is defined as the per cent of patients with STIs who are given advice on condom use and partner notification and referral for HIV testing in term of national standards; (3)Standardised STI service indicator (SSI) means the comprehensive case management including SI1 and SI2. The sample size of STI patients between provider and client interactions observed was 40 per county according to the recommendation of national experts. Data were collected in observations of provider-client interaction at the health-care facilities offering STI services by trained professionals. The software of EpiData3.1 and SPSS 11.5 was used to data entry and analysis.

Results From 2007 to 2009, the SI1 was 46.16% (397/860) (95% CI 42.83% to 49.49%), 62.94% (603/958) (95% CI 59.88% to 66.00%), 81.96% (686/837) (95%CI 79.35% to 84.57%) on average in 21 counties, respectively, and there was significantly increased trends (χ2 is 234.30, p=0.000); the SI2 was 28.32% (243/858) (95%CI 25.31% to 31.33%), 45.04% (431/957) (95% CI 41.89% to 48.19%), 80.33% (678/844) (95% CI 77.65% to 83.01%) on average for these counties, respectively, and there was also significantly increased trends (χ2 is 459.37, p=0.000). For overall STI service quality, SSI was 20.98% (180/858) (95% CI 18.26% to 23.70%), 40.02% (383/957) (95% CI 36.92% to 43.12%), 67.26% (563/837) (95% CI 64.08% to 70.44%), respectively in 2007–2009, and there was significantly increased trends (χ2 is 370.81, p=0.000). The STI service indicators in rich areas were higher than in poor counties.

Conclusions The quality of STI services was significantly improved through the Global Funds Round 4 in 21 counties of seven provinces in China, and should be scaled up to other areas in the country.

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