Population-based interventions for reducing sexually transmitted infections, including HIV infection
RHL practical aspects by Schulz KF
FIRST CONTACT (PRIMARY CARE) LEVEL
The Mwanza-type intervention would primarily be dealt with at the first contact level. The critical aspect is for the sexually transmitted infection (STI) services to be easily accessible, which would usually place them at the lowest health care level available.
REFERRAL HOSPITAL (SECONDARY CARE) LEVEL
The basic idea of syndromic case management is to stay away from costly laboratory procedures at this secondary care level. Initial survey of the STI landscape and tailoring of syndromic case management should limit the need to use secondary care.
AT HOME OR IN THE COMMUNITY
The Mwanza intervention involved village campaigns to improve treatment-seeking behaviour. Any information provided to the community that can improve treatment-seeking behaviour greatly enhances a syndromic management approach. If patients do not recognize symptoms, they simply cannot access treatment.
This document should be cited as: Schulz K KF. Population-based interventions for reducing sexually transmitted infections, including HIV infection: RHL practical aspects (last revised: 24 June 2004). The WHO Reproductive Health Library; Geneva: World Health Organization.