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Sexually transmitted infections: comprehensive case management

Export Indicator

Percentage of women and men with sexually transmitted infections at health-care facilities who are appropriately diagnosed, treated and counseled  
What it measures

 To assess progress in implementing universally effective sexually transmitted infection diagnosis, treatment and counselling. The risk of HIV transmission is substantially increased when one or both partners in a sexual relationship have another sexually transmitted infection. Thus, the availability and utilization of services to treat and contain the spread of sexually transmitted infections can reduce the rate of HIV transmission within a population. One of the corner stones of sexually transmitted infection control is comprehensive case management of patients with symptomatic sexually transmitted infections.

 

Rationale
Numerator

Number of sexually transmitted infection patients for whom the correct procedures were followed on: (a) history-taking; (b) examination; (c) diagnosis and treatment; and (d) effective counselling on partner notification, condom use and HIV testing.

Denominator

Number of sexually transmitted infection patients for whom provider-client interactions were observed.

Calculation
Method of measurement

 Data are collected in observations of provider-client interaction at a sample of health care facilities offering sexually transmitted infection services. See reference on: Evaluation of a national AIDS programme: A methods package UNAIDS/WHO (1994) for details on how to select this sample. Providers are assessed on history taking, examination, proper diagnosis and treatment of patients, and effective counselling including counselling on partner notification, condom use and HIV testing.
“Appropriate” diagnosis and treatment and counselling procedures in any given country, are those specified in national sexually transmitted infection service guidelines.
A “health-care” facility is defined as any setting (i.e., including public, private, and church sectors) where health-care services are provided by one or more medically qualified personnel.
Disaggregated indicator scores should be reported for men and women and for patients under and over 20 years of age.
Scores for each component of the indicator (i.e., history-taking, examination, diagnosis and treatment, and counselling) must be reported as well as the overall indicator score.
 
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Measurement frequency

Biennial

Disaggregation

Age group: 15 years - 19 years, 20 years - 24 years, > (greater than) 25 years

Condom type: N/A

Education: N/A

Gender: Male, Female

Geographic location: N/A

HIV status: N/A

Pregnancy status: N/A

Sector: N/A

Service Type: N/A

Target: N/A

Time period: N/A

Type of orphan: N/A

Vulnerability status: N/A

Explanation of the numerator
Explanation of the denominator
Strengths and weaknesses

• This composite indicator reflects the competence of health-service providers to correctly identify and treat sexually transmitted infections, the availability of the necessary equipment, drugs and materials, and the provision of appropriate counselling to patients.
• The indicator reflects the quality of services provided but not the cost or accessibility of these services.
• The standard for “appropriate” care upon which the measurement of the indicator is based may vary between countries (or over time). Currently, syndromic management is seen as the most practical approach in high-prevalence, low-income countries since there are fewer bottlenecks in diagnosis.

Further information