Improved reproductive health and STD services for women presenting to family planning services in North Jakarta. Final report of activities

Abstract

The overall goal of this study was to develop an integrated program of reproductive tract infection/sexually transmitted disease (RTI/STD) clinical services within two family planning clinics in low-income neighborhoods in North Jakarta. Multiple training programs to introduce a standardized clinical evaluation for the detection, treatment, and management of RTI/STDs were conducted. Prior and subsequent to training, observations of health care provider (HCP) and client interactions were conducted to evaluate behavior changes among HCPs. Each consenting client received a standardized reproductive health history, a pelvic exam, and provided specimens for laboratory testing to detect RTIs. Through universal screening of the participants by an STD referral laboratory, 25 percent were confirmed to have one or more RTIs while 14 percent had one or more STDs. HCPs were observed by trained research assistants who recorded an itemized evaluation of HCP behavioral components. As noted in this report, the 70-item observation tool showed a preference for performing physical examinations, and a reluctance to perform history taking, education, partner treatment plans, and prevention counseling.