Authors ' conclusions Training probably improves quality of care ( i.e. adherence to recommended practice ) , regulation may improve quality of care , and we are uncertain about the effects of co‐ordination on quality of private for‐profit healthcare services in LMICs .
Background Governments use different approaches to ensure that private for‐profit healthcare services meet certain quality st and ards .
Such government guidance , referred to as public stewardship , encompasses government policies , regulatory mechanisms , and implementation strategies for ensuring accountability in the delivery of services .
However , the effectiveness of these strategies in low‐ and middle‐income countries ( LMICs ) have not been the subject of a systematic review .
Objectives To assess the effects of public sector regulation , training , or co‐ordination of the private for‐profit health sector in low‐ and middle‐income countries .
Impact of an intervention to improve treatment-seeking behavior and prevent sexually transmitted diseases among Nigerian youths.
BACKGROUND Interventions to treat STDs have been reported to reduce HIV incidence . Interventions to improve treatment-seeking for STDs may impact on the duration and prevalence of STDs . Nigeria has high rates of STDs and an increasing incidence of HIV . OBJECTIVE To evaluate the impact of an intervention on STD treatment-seeking behavior and STD prevalence among Nigerian youth . METHODS A r and omized controlled trial in 12 schools in Edo State was conducted to evaluate an intervention to improve STD treatment-seeking and STD treatment provision . The intervention , based on formative research , consisted of community participation , peer education , public lectures , health clubs in the schools , and training of STD treatment providers , including those with no formal training . A question naire measured outcomes before and 10 months into the intervention . The effect of the intervention among four r and omly selected intervention schools compared to eight r and omly selected control schools was assessed using logistic regression with Huber 's formula to account for school clusters . RESULTS One thous and eight hundred and ninety-six and 1858 youths 14 - 20 years of age were enrolled in the pre- and post-intervention surveys . Youths in the intervention schools , compared to control schools , reported statistically significant improvements in knowledge of STDs , condom use , partner awareness that the youth had an STD , and STD treatment-seeking behavior . Treatment by private physicians increased ( OR=2.1 , 95 % CI=1.1 - 4.0 ) , and treatment by patent medicine dealers or pharmacists decreased ( OR=0.44 , 95 % CI=0.22 - 0.88 ) . The reported prevalence of STD symptoms in the past 6 months was significantly reduced in the intervention compared to control schools ( OR=0.68 , 95 % CI=0.48 - 0.95 ) . CONCLUSION Significant improvements in treatment-seeking for STD symptoms can be effected among Nigerian youths . The prevalence of reported STD symptoms can be decreased by improving treatment-seeking for and awareness of STDs
Authors ' conclusions Training probably improves quality of care ( i.e. adherence to recommended practice ) , regulation may improve quality of care , and we are uncertain about the effects of co‐ordination on quality of private for‐profit healthcare services in LMICs .
Background Governments use different approaches to ensure that private for‐profit healthcare services meet certain quality st and ards .
Such government guidance , referred to as public stewardship , encompasses government policies , regulatory mechanisms , and implementation strategies for ensuring accountability in the delivery of services .
However , the effectiveness of these strategies in low‐ and middle‐income countries ( LMICs ) have not been the subject of a systematic review .
Objectives To assess the effects of public sector regulation , training , or co‐ordination of the private for‐profit health sector in low‐ and middle‐income countries .