Population Council Research that makes a difference

Sexually transmitted and other reproductive tract infections (STIs/RTIs) present a major burden of disease in Kenya and are responsible for high levels of maternal and infant morbidity and mortality. To address the high prevalence of STIs/RTIs globally by increasing access to detection and management services, the World Health Organization (WHO), in partnership with the Population Council and Family Health International, developed guidelines for integrating these services into other sexual and reproductive health services in primary health care settings. By June 2006, these guidelines were adapted at the national level in Kenya and led to the launch of Kenya's national guidelines on the integration of services for reproductive tract infections.

This project, led by the Council with funding from the WHO and the United Nations Population Fund (UNFPA), evaluated the feasibility, acceptability, and effect of introducing these guidelines on the quality of care provided and the incremental costs in ten health facilities. The intervention included revising the original training materials and job aides, training health providers, modifying Ministry of Health registers, strengthening commodity logistics, enhancing supportive supervision, and providing regular monitoring. Data for the evaluation were collected through observations of provider–client interactions, client exit interviews, and an assessment of each health facility.

Overall, the results showed that integration of activities to screen for and manage STIs/RTIs into reproductive health services is feasible, acceptable to clients and providers, and effective in improving the range and quality of services offered to clients. Feedback from both providers and clients showed that integration of services was acceptable to them. Significant improvements in the range and quality of care occurred in all four service areas (family planning, antenatal care, maternity/delivery, and postnatal/postpartum).