Strategy to reduce impact of STIs being finalised

Guyana will soon have its first “comprehensive” Sexual Transmitted Infections (STI) Strategic Plan in the coming months, placing more focus on diseases which have been overshadowed by HIV/AIDS.

It was in recognition of the serious health, social, emotion and economic consequences of STIs that a draft strategy plan, which will cover this year through to 2020, was developed by the Ministry of Health. The Ministry, through the National Aids Programme Secretariat (NAPS), is committed to providing national leadership in collaboration with local, regional, national and international partners to develop the plan to manage and prevent STIs in Guyana.

The main goal of the plan is to “reduce the transmission and morbidity and mortality caused by STIs and to minimise the personal and social impact of the infections.”

The draft plan was developed through what was described as an inclusive and broad consultative process spearheaded by the ministry and supported by the Pan-American Health Organisation/World Health Organisation (PAHO/WHO). It is in its final stages of completion and on Monday the ministry held the final round of consultative processes at the Cara Lodge, where the plan was discussed with various stakeholders, whose inputs are to be taken on board in the completion of the final document. STIs in Guyana were found to have increased from 2007 to 2009, with a small decrease seen in 2010, according to Ministry of Health surveillance data cited in the draft. However, the noted trend, the plan said, may be partially attributed to the surveillance system strengthening, which included implementation of revised communicable disease surveillance forms, along with an increase in sites providing STI treatment and care.

A 2004 study had found that awareness of STIs among the most at risk populations was generally high, with rates of self reported leak and genital sores/boils noted among the female sex workers, Men who have Sex with Men (MSM) and in school youth, with the lowest rates seen for the military and police. However, according to the draft plan there is currently no baseline information on STI knowledge and behaviour in the general population and very limited data is available on the prevalence of specific STIs in either the general population or in higher risk groups, such as female sex workers and MSM.

The strategy has identified five priority areas: the strengthening of the STI programme management and coordination; promoting healthy sexual behaviours to reduce the transmission of STIs; expanding access to STI prevention, care and treatment in health sector; increasing access to medicines, vaccines, diagnostics and laboratory support; and improving the availability of strategic information. It is hoped that the plan will provide the structural framework to guide the coordination, implementation and evaluation of the national response to STIs in Guyana and to serve as a mechanism for the engagement of partners and stakeholders involved in the STI programme. Further, the plan will serve as an advocacy tool for the support of the national STI programme. During the next few years, it is hoped that through the plan there would be an increase in the national capacity to manage and coordinate the STI programme and in an intensification of strategies aimed at primary and secondary prevention. Also it is aimed at the strengthening of the health system to provide quality and efficient STI services through the enhancement of the national laboratory quality and procurement and supplies management system.

The plan will take a seven-pronged approach to achieve prevention and control of STIs. These include: the STI response based on multi-sectoral collaboration; integration of STI services into HIV services; integration of STI services into other services; strengthening of health systems for comprehensive STI service delivery; improvement in strategic information; and the reduction of vulnerability and stigma and discrimination.

During the ten year implementation period of the plan, it was pointed out that funding would be a key requirement for the implementation of many of the components. Although donor interest in and support to combats STIs have been limited in the past, it is believed that opportunities do exist to enhance synergies with activities supported by HIV-related funding.

“STI initiatives such as health system strengthening, integration into Maternal and Child Health Services and the elimination of congenital syphilis, among others, are tools that can be used to advocate for greater funding,” the draft document stated.

It was, however, also noted that emerging issues in the global agenda may result in a decrease in the availability of resources for the implementation of the plan.

The draft document indicated that it will be important for the progress of the plan to be monitored and this will be facilitated through mid-term and end evaluations, which will aim to answer specific management questions and judge the overall value of the programme as well as determine the efficiency, effectiveness, impact, sustainability and relevance of the programme as well as the interventions. The evaluations are also expected to provide information that is credible and useful, and will offer concrete lessons to make decisions. Meanwhile, a quality management system will be implemented for STIs, with the aim of improving the quality of STI care at care treatment sites. A set of indicators will be used in STI settings to measure the quality of patient care, and also describe the general performance of the institutions providing STI care and treatment services. The data will be aggregated to provide a national report as well as other specific reports.

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