Assessment for health system requirements for inclusion of Chlamydia and Trichomoniasis screening in the routine ANC screening in Kenya

Reference Number: 
PGD5/SMasha/Health systems assessement
Location: 
Kilifi
Country: 
Kenya
Supervisor: 
Dr Simon Masha, Dr Edwine Barasa and Dr Benjamin Tsofa
Description: 

 

Background

Women attending Antenatal Care (ANC) clinics in Kenya and many other Low and Middle Income Countries (LMICs) are routinely etiologically screened for HIV and syphilis but not for other curable STIs. Recently among pregnant women attending ANC clinic in Kilifi, Kenya we established that one in five women was infected with at least one curable STI (Masha et al., 2017). The high burden of curable STIs was attributed to the prevalence of Chlamydia and Trichomoniasis which had a prevalence of 14.9% and 7.4% respectively (Masha et al., 2017). This high burden is consistent with the generally high burden of curable STIs in SSA (Newman et al., 2015). The adopted approach for screening management of STIs in ANC employs the use of a syndromic algorithm. However, the syndromic approach has been shown to be deficient in both sensitivity and specificity which can be attributed to asymptomatic nature of many STI cases or non-specific clinical signs and symptoms (Fonck et al., 2000). Several points of care tests are now available for quick and reliable detection of STIs and ought to be considered for screening curable STIs. Effective management of curable STIs among pregnant women is essential for reducing the burden of curable STIs, lessening the incidence of HIV and decreasing adverse pregnancy outcomes.

The 2018 Kenya national guidelines for prevention, management and control of STIs recommend that all pregnant women aged <25 years and older women at increased risk for infection should be routinely screened for other STIs besides HIV and Syphilis. We propose to perform a feasibility assessment of health system requirements including determining direct costs of including etiologic diagnosis of two STIs (Chlamydia, Trichomoniasis) as part of STI screening offered to women attending ANC clinic in public health facilities.

This proposed studentship will specifically focus on point of care screening tests for routine screening for Chlamydia trachomatis and Trichomonas vaginalis. And documenting the views, perceptions and acceptability of the available point of care tests for Chlamydia trachomatis and Trichomonas vaginalis.

 

Questions to be addressed by the student

  1. What point of care screening tests are available for routine screening for Chlamydia trachomatis and Trichomonas vaginalis?
  2. What are Kenyan sub-national level stakeholders’ (clients, providers, managers, etc) views, perceptions and acceptability of the available point of care tests for Chlamydia trachomatis and Trichomonas vaginalis?

 

Skills to be acquired by the student

The student will gain skills in the design, conduct and analysis of health systems and health policy research utilising qualitative methods including, observations and, individual and group interviews. Student will also gain scientific writing skills, literature searching skills, and insights into health system governance.

 

Preferred training background of the student

  1. Health Sciences
  2. Experience in in-depth interviews and FGDs
  3. Ability to work independently
  4. Excellent communication skills and good team player

 

Application deadline: 11 February 2019