Provider Characteristics Among Staff Providing Care to... : Sexually Transmitted Diseases (original) (raw)

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Provider Characteristics Among Staff Providing Care to Sexually Transmitted Infection Self-Medicating Patients in Retail Pharmacies in Kibera Slum, Nairobi, Kenya

Kwena, Zachary MA*; Sharma, Anjali DSc*; Wamae, Njeri PhD*; Muga, Charles MA*; Bukusi, Elizabeth PhD*†

From the *Centre for Microbiology Research, Kenya Medical Research Institute, and †Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya

We are grateful to the Center for Microbiology Research's scientific committee who reviewed the design and relevance of the study. We also appreciate the assistance by Norton Mutai and Charity Maingi in the clinical analysis of the data and Boniface Keya and Richard Adede for collecting the data for the study. We thank Director, Kenya Medical Research Institute for permission to publish this work.

Anjali Sharma is currently at Liverpool, UK.

Supported by the Organization of Social Science Research in Eastern and Southern Africa (OSSREA).

Correspondence: Zachary A. Kwena, Social Scientist/Study Coordinator, Center for Microbiology Research, Research, Care and Training Program (RCTP), Kenya Medical Research Institute, P.O. Box 614 40100, Kisumu. E-mail: [email protected].

Received for publication July 29, 2007, and accepted December 4, 2007.

Objectives:

To evaluate the characteristics of providers in management of STI self-medicating patients in retail pharmacies within the largest informal settlement in Kenya.

Methods:

We collected sociodemographic, training, and work history attributes among pharmacy staff from a convenience sample of 50 retail pharmacies in Kibera slum using a self-administered questionnaire. We gathered the required data in 8 weeks, collecting completed self-administered questionnaires within 7 to 14 days after distribution. Two data collectors subsequently presented at these pharmacies as mystery patients seeking care for symptoms of genital ulcer disease and gonorrhea and completed a structured observation form within 10 minutes of leaving the pharmacy.

Results:

Approximately half the respondents were men aged less than 28 years. Over 90% had 12 years of formal education and an additional 3 years of medical professional training. Two thirds (66%) had been trained in Government institutions. About 65% reported that patients presented without prescriptions, and 45% noted that patients requested specific medicines but were open to advice. One-third (36%) of the patients used the pharmacy as their first point of care. Using mystery patients to evaluate syndromic management of gonorrhea and genital ulcer disease, only 10% offered appropriate treatment per the Kenya Ministry of Health STI syndromic management guidelines.

Conclusion:

Although the majority of the pharmacy staff in this informal settlement have some medical training and some experience, a very low proportion offered adequate treatment for 2 common STIs.