Uptake of STI Services in Lagos State

Background: Literature confirms that health-seeking behaviour in developing countries indicate that many with symptomatic STI seek treatment in the informal/private sectorand will only receive formal public healthcare whenthese fail. Study objectivewas to determine STI patients patronage of healthcare services in Lagos state with a view to improving practice of the most patronized source.

Methods: Survey of casefiles in hospitals (secondary and tertiary) was carried out using a modified WHO/INRUD prescribing indicator form to determine level of patronage and mode of treatment. From community pharmacies list, a sample size of 179 pharmacies was determined from 10 zones which were randomly selected. Pharmacists were administered a validated questionnaire to obtain information on level of patronage and knowledge/practice of STI management. An educational intervention, preceded by a pre-test,by means of face-to-face seminarwascarried out for pharmacists usingWHO standardized syndromic management training pack. Data was collected four(4) and twelve(12) weeks post training using the original pre-test questionnaire and analyzed. P<0.5 was taken as significant.

Results: One tertiary and 8 secondary hospitals, and 156 pharmacies (87% recovery) were involved in study.The result shows that in the hospitals, STI syndromic approach is the mode of treatment used. About 91 patients use the STI clinic in the tertiary hospital while374 patients use secondary hospitals per year. About 572clients present in pharmacies with complaints of STIs per year and statistically significant difference exists in pharmacists’ knowledge/practice rating and intervention status. Post-hoc determinations showed that significant difference were between pre-test and both post intervention times. Respondents’ definition, knowledge about, use of and possession of the charts improved significantly post intervention.

Conclusions: It can be concluded that the level of patronage of hospitals by STI patients is low. Community pharmacists can provide appropriate STI management to patients using the syndromic approach if trained & monitored. It is recommended that relevant regulatory bodies should provide an enabling framework for this.