Department of Reproductive Health and Research (RHR), World Health Organization
Sexually transmitted and other reproductive tract infections
A guide to essential practice
The role of clinical services in reducing the burden of STI/RTI
There are a number of challenges to providing effective STI/RTI services to the people who need them (Figure 1.3). Many people with an STI/RTI do not seek treatment because they are asymptomatic or have mild symptoms and do not realize that anything is wrong. Others who have symptoms may prefer to treat themselves or seek treatment at pharmacies or from traditional healers. Even those who come to a clinic may not be properly diagnosed and treated. In the end, only a small proportion of people with an STI/RTI may be cured and avoid reinfection; this Guide aims to help increase that proportion.
Figure 1.3. Challenges of STI/RTI service provision
Many of these challenges can be addressed by making the most of opportunities to promote prevention, improve health-seeking behaviour, and detect and manage existing infections. Health care providers should:
STI/RTI services should never be seen as an optional component of reproductive health services. The 1994 International Conference on Population and Development, held in Cairo, Egypt, emphasized that provision of clinical services to reduce STIs in family planning services was essential for ensuring a healthy reproductive future. Clearly, there is an opportunity to reach many women whose only contact with the health care system is reproductive health services. Most of these women are sexually active, many are at risk of infection and some have an existing infection.
A combined strategy of effective community interventions and improved clinical services can have a large impact on STIs/RTIs and their complications. Better clinical services increase the number of people who are cured. More effective prevention in the community, especially when it reaches those at highest risk, can reduce the overall STI/RTI problem. The combination of strategies benefits everyone.
Infections of the male and female reproductive tract and their consequences:
Preventing STIs/RTIs and their complications
STI/RTI education and counselling
Promoting prevention of STI/RTI and use of services
STI/RTI Assessment during Routine Family Planning Visits
STI/RTI Assessment in pregnancy, childbirth and the postpartum period
Management of symptomatic STIs/RTIs
STI/RTI complications related to pregnancy, miscarriage, induced abortion, and the postpartum period
Annex 1. Clinical skills needed for STI/RTI
Annex 2. Disinfection and universal precautions
Annex 3. Laboratory tests for RTI
Annex 4. Medications