An Assessment of Sexually Transmitted Infection Management at the Primary Health Care Level in a Local Government in Northern Nigeria

Background: The control of Sexually Transmitted Infections (ST Is) is an important strategy in reproductive health and HIV/AIDS control. It should be such that comprehensive management of patients with ST Is is available at the primary health care level. This study was to assess the quality of ST I care at the primary health care level in Zaria. Method: It was a descriptive cross-sectional study in which a three-part structured questionnaire was administered to all staff who provided clinical services to patients seeking ST I services in the 28 operational health centres in the local government area and these facilities were also assessed using a checklist. Results: Over half of the respondents are females (54.5%), while the modal age group was 35-39years (36.4%). Most of the staff providing clinical including ST I services were Senior Community Health Extension Workers (SCHEWS) (72.7%) with only 5(9.1%) nurses/midwives and 2(3.5%) being Community Health Officers (CHOs). There were training gaps identified with only 16.3% trained on STI counseling only; the 3.6% trained on syndromic management were the CHOs who had no knowledge of the 4Cs of syndromic management. While counseling of patients was routinely done by 92.7% of respondents and 70.9% promoted the use of condoms; assessment of attitude to ST Is showed that 70.9% of respondents felt that ST Is are as a result of promiscuity, 78.2% believed that condoms would encourage promiscuity and 45.5% felt religion is against the use of condoms. However, 92.7% are of the opinion that condom use is protective against ST Is. Many of the respondents (81.8%) support that all STI patients be screened for HIV; while 23.6% support the screening of spouses for STIs. Assessment of facilities available at the health centres show that none was adequately equipped for the syndromic management of ST Is. No centre had the syndromic management manual or chart; none had the STI-01 or -02 reporting forms. Only 39.3% had drug dispensing sections. Conclusion: Primary prevention of STI should be an integral part of the PHC package; conscious effort should be made to involve the PHC level in the surveillance and treatment of ST Is by proper training and provision of pertinent materials.