School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
Department of Biomedical Science, Faculty of Natural Science, Mangosuthu University of Technology, KwaZulu-Natal, South Africa.
BMC Health Serv Res. 2024 Jan 18;24(1):106. doi: 10.1186/s12913-023-10353-6.
Syndromic management in the main non-laboratory-based management approach for sexually transmitted infections (STI) in most low- and middle-income countries (LMICs) but it has limitations. Self-sampling has been proven as a suitable alternative approach to help improve management STIs by improving access to diagnosis among vulnerable populations. We sought to determine health workers' perspectives on user-friendly self-sampling interventions for STIs among young women in eThekwini District Municipality.
Healthcare workers providing STI healthcare services in the study location participated in a nominal group technique (NGT) workshop. The NGT workshop was aimed enabling collaboration with key health providers in identifying user-friendly self-sampling interventions for diagnosis of STIs among young women. Data collection was conducted in two phases: phase 1 determined barrier that hinder young women from accessing current STI healthcare services and phase 2 focused on determining the key strategies for self-sampling interventions to diagnose STIs in young women. Thematic analysis and percentage form analysis were used to examine qualitative and quantitative data respectively.
The following barriers were identified: negligence; myths about STIs; fear of judgement; denial; operating hours; lack of knowledge of STI symptoms and safe sex practices; and stigma associated with STIs. The following strategies were suggested: hand out self-sampling kits at popular restaurants; collect self-sampling kits from security guard at primary healthcare clinics (PHCs); receive STI diagnostic results via SMS or email or the clinic for treatment; improve youth friendly services at PHCs; educate the public on proper use of the kits. Education about STIs and handing out self-sampling kits at clinics, universities, schools, pharmacies or via outreach teams were ranked high priority strategies.
The findings highlight the need to address stigma and fear of judgment and provide comprehensive education to improve healthcare-seeking behaviour in young women. Additionally, the study also indicates that using eHealth solutions could significantly enhance the accessibility and efficiency of STI healthcare services in LMICs.
在大多数中低收入国家(LMICs),综合征管理是性传播感染(STI)的主要非实验室管理方法,但它存在局限性。自我采样已被证明是一种合适的替代方法,可以通过改善弱势群体获得诊断的机会来帮助改善 STI 的管理。我们试图确定卫生工作者对易使用的自我采样干预措施的看法,以改善 eThekwini 地区市政当局年轻女性的 STI 管理。
在研究地点提供 STI 医疗服务的医疗保健工作者参加了名义群体技术(NGT)研讨会。NGT 研讨会旨在使关键卫生提供者能够合作,确定针对年轻女性 STI 诊断的易用性自我采样干预措施。数据收集分两个阶段进行:第 1 阶段确定了阻碍年轻女性获得当前 STI 医疗服务的障碍,第 2 阶段侧重于确定针对年轻女性 STI 诊断的自我采样干预措施的关键策略。主题分析和百分比分析分别用于检查定性和定量数据。
确定了以下障碍:疏忽;对 STI 的误解;对评判的恐惧;否认;营业时间;缺乏对 STI 症状和安全性行为的认识;以及与 STI 相关的耻辱感。提出了以下策略:在受欢迎的餐馆分发自我采样工具包;从初级保健诊所(PHC)的保安那里收集自我采样工具包;通过 SMS 或电子邮件或诊所接收 STI 诊断结果进行治疗;改善 PHC 的青年友好服务;对套件的正确使用进行教育。在诊所、大学、学校、药店或通过外展团队进行 STI 教育和分发自我采样工具包被列为高度优先的策略。
研究结果强调需要解决耻辱感和对评判的恐惧,并提供全面的教育,以改善年轻女性的医疗服务寻求行为。此外,研究还表明,使用电子卫生解决方案可以显著提高 LMICs 中 STI 医疗服务的可及性和效率。