Fewer than five percent of these patients were referred to the clinic at the central hospital, a reduction of more than one-third from the year prior to the start of the project. The decline in referrals suggests effective use of clinical algorithms and strategies at the first level of care, in the primary health care centers. The planning process was managed by highly motivated and committed individuals and involved all interested constituents in ministries, laboratories, and health services. The project respected national guidelines and followed established procedures for drug procurement rather than installing potentially confusing parallel procurement channels. Short, targeted training courses prior to the implementation of program services enable health care providers to learn and immediately practice new skills.
Syndromic management allows project services to reach more of the at-risk female population.
P.O. Box 1164, Hospital Central de Maputo, Maputo, Mozambique. Program managers and service providers worked with the community to identify and respond to health and program needs. FLEP responded by training existing staff, developing appropriate IEC materials and activities, developing a risk assessment checklist, establishing an HIV testing system, designing mechanisms for treatment of complications, and improving clinic facilities. Identification and referral of clients for HIV testing. Diagnosis and treatment of clients with STIs using syndromic management.