Stakeholders’ perceptions of the delivery and quality of sexually transmitted infection treatment by private practitioners in Windhoek, Namibia

The primary objective of this study was to explore the perceptions of the community and other stakeholders regarding the delivery and quality of sexually transmitted infection (STI) treatment and care provided by private general practitioners (PGPs) in Windhoek, Namibia. The study provided a situational and contextual analysis employing qualitative methodologies using different methods of data collection. The methodology used included (1) a review of available country policy documents on STI management and surveillance, as well as the policy with regard to private primary care providers, (2) eight in-depth interviews conducted with key informants and (3)three focus-group discussions held with community members attending PGP practices in Windhoek. The perceptions of the care received from PGPs differed from one person to the next. It emerged that some participants had good experiences and some had negative experiences of the care given.The participants believed that going to a PGP for treatment is a matter of affordability that goes hand in hand with the expectations of receiving care, whilst maintaining confidentiality. The study established that there is no real difference between the care provided to patients with medical aid or those without medical aid. It is recommended that interactions between the public and private sector at various levels be initiated to ensure that curable STIs are appropriately managed and that national guidelines for STI management are adhered to. Health workers should also be sensitised about their approach towards patients. It is further recommended that awareness creation amongst PGPs with regard to the public health importance of STIs needs to be raised to encourage them to participate in the STI-control programme. Opsomming Die hoofdoel van die studie was om ondersoek in te stel na die persepsies van die gemeenskap en ander belanghebbendes oor die lewering en kwaliteit van die behandeling en sorg ten opsigte van seksueel oordraagbare infeksies (SOIs) deur privaat algemene praktisyns in Windhoek. Die studie het ’n situasionele en kontekstuele analise behels, waarin gebruik gemaak is van kwalitatiewe metodologieë en verskillende metodes van data-insameling. Die metodologie het ingesluit (1) die bestudering van beskikbare nasionale beleidsdokumente oor die behandeling en monitering van SOIs sowel as die beleid op privaat primêresorgvoorsieners, (2) agt diepteonderhoude met sleutelinformante en (3) drie fokusgroepgesprekke met lede van die gemeenskap wat die praktyke van privaat algemene praktisyns in Windhoek besoek. Die persepsies van die sorg wat van algemene praktisyns ontvang is, verskil van deelnemer tot deelnemer. Dit het aan die lig gekom dat sommige deelnemers die gelewerde sorg positief ervaar het terwyl ander dit negatief ervaar het. Die deelnemers het geglo dat om ’n algemene praktisyn vir behandeling te besoek ’n kwessie van bekostigbaarheid is wat gepaard gaan met ’n verwagting van sorglewering terwyl vertroulikheid behou word. Die studie het bevind dat daar geen verskil is in die sorg wat gelewer word aan pasiënte met ’n mediese fonds teenoor dié daarsonder nie. Daar word aanbeveel dat interaksie op verskillende vlakke tussen die openbare en privaat sektor aangemoedig moet word om te verseker dat behandelbare SOIs voldoende bestuur word en dat die nasionale riglyne ten opsigte daarvan nagekom word. Gesondheidswerkers behoort gesensitiseer te word ten opsigte van hul benadering tot hul kliënte. Daar word verder aanbeveel dat die bewusmaking van die openbaregesondheidsbelang van SOIs onder privaat praktisyns opgeskerp moet word sodat hulle aan die SOI-beheerprogram sal deelneem