Opportunities and barriers to STI testing in community health centres in China: A nationwide survey

Jason J. Ong, Minghui Peng, Shanzhu Zhu, Ying Ru J. Lo, Christopher K. Fairley, Michael R. Kidd, Martin Roland, Sunfang Jiang, William C.W. Wong

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background China has strengthened its primary care workforce and implemented a wide network of community health centres (CHCs). However, STI testing and management are not currently included in the 'Essential Package of Primary Health Care in China'. Legislation change to encourage STI service delivery would be important, but it is also critical to determine if there are also provider-related opportunities and barriers for implementing effective STI programmes through CHCs if future legislation were to change. Methods A national representative survey was conducted between September and December 2015 in a stratified random sample of 180 CHCs based in 20 cities in China. Primary care practitioners (PCPs) provided information on current experiences of STI testing as well as the barriers and facilitators for STI testing in CHCs. Multivariate logistic regression was conducted to determine factors associated with PCPs performing STI testing. Results 3580 out of 4146 (86%) invited PCPs from 158 CHCs completed the survey. The majority (85%, 95% CI 84% to 87%) of doctors stated that STI testing was an important part of healthcare. However, less than a third (29%, 95% CI 27% to 31%) would perform an STI test if the patients asked. Barriers for performing STI testing included lack of training, concerns about reimbursement, concerns about damage to clinics' reputations and the stigma against key populations. Respondents who reported that they would perform an STI test were likely to be younger, received a bachelor degree or higher, received specific training in STIs, believed that STI test was an important part of healthcare or had resources to perform STI testing. Conclusions There is potential for improving STI management in China through upskilling the primary care workforce in CHCs. Specific training in STIs is needed, and other structural, logistical and attitudinal barriers are needed to be addressed.

Original languageEnglish
Pages (from-to)566-571
Number of pages6
JournalSexually Transmitted Infections
Volume93
Issue number8
DOIs
Publication statusPublished - 1 Dec 2017

Keywords

  • China
  • community services
  • health services research
  • Infection control
  • primary care
  • service delivery

Cite this

Ong, Jason J. ; Peng, Minghui ; Zhu, Shanzhu ; Lo, Ying Ru J. ; Fairley, Christopher K. ; Kidd, Michael R. ; Roland, Martin ; Jiang, Sunfang ; Wong, William C.W. / Opportunities and barriers to STI testing in community health centres in China : A nationwide survey. In: Sexually Transmitted Infections. 2017 ; Vol. 93, No. 8. pp. 566-571.
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title = "Opportunities and barriers to STI testing in community health centres in China: A nationwide survey",
abstract = "Background China has strengthened its primary care workforce and implemented a wide network of community health centres (CHCs). However, STI testing and management are not currently included in the 'Essential Package of Primary Health Care in China'. Legislation change to encourage STI service delivery would be important, but it is also critical to determine if there are also provider-related opportunities and barriers for implementing effective STI programmes through CHCs if future legislation were to change. Methods A national representative survey was conducted between September and December 2015 in a stratified random sample of 180 CHCs based in 20 cities in China. Primary care practitioners (PCPs) provided information on current experiences of STI testing as well as the barriers and facilitators for STI testing in CHCs. Multivariate logistic regression was conducted to determine factors associated with PCPs performing STI testing. Results 3580 out of 4146 (86{\%}) invited PCPs from 158 CHCs completed the survey. The majority (85{\%}, 95{\%} CI 84{\%} to 87{\%}) of doctors stated that STI testing was an important part of healthcare. However, less than a third (29{\%}, 95{\%} CI 27{\%} to 31{\%}) would perform an STI test if the patients asked. Barriers for performing STI testing included lack of training, concerns about reimbursement, concerns about damage to clinics' reputations and the stigma against key populations. Respondents who reported that they would perform an STI test were likely to be younger, received a bachelor degree or higher, received specific training in STIs, believed that STI test was an important part of healthcare or had resources to perform STI testing. Conclusions There is potential for improving STI management in China through upskilling the primary care workforce in CHCs. Specific training in STIs is needed, and other structural, logistical and attitudinal barriers are needed to be addressed.",
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Opportunities and barriers to STI testing in community health centres in China : A nationwide survey. / Ong, Jason J.; Peng, Minghui; Zhu, Shanzhu; Lo, Ying Ru J.; Fairley, Christopher K.; Kidd, Michael R.; Roland, Martin; Jiang, Sunfang; Wong, William C.W.

In: Sexually Transmitted Infections, Vol. 93, No. 8, 01.12.2017, p. 566-571.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Opportunities and barriers to STI testing in community health centres in China

T2 - A nationwide survey

AU - Ong, Jason J.

AU - Peng, Minghui

AU - Zhu, Shanzhu

AU - Lo, Ying Ru J.

AU - Fairley, Christopher K.

AU - Kidd, Michael R.

AU - Roland, Martin

AU - Jiang, Sunfang

AU - Wong, William C.W.

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Background China has strengthened its primary care workforce and implemented a wide network of community health centres (CHCs). However, STI testing and management are not currently included in the 'Essential Package of Primary Health Care in China'. Legislation change to encourage STI service delivery would be important, but it is also critical to determine if there are also provider-related opportunities and barriers for implementing effective STI programmes through CHCs if future legislation were to change. Methods A national representative survey was conducted between September and December 2015 in a stratified random sample of 180 CHCs based in 20 cities in China. Primary care practitioners (PCPs) provided information on current experiences of STI testing as well as the barriers and facilitators for STI testing in CHCs. Multivariate logistic regression was conducted to determine factors associated with PCPs performing STI testing. Results 3580 out of 4146 (86%) invited PCPs from 158 CHCs completed the survey. The majority (85%, 95% CI 84% to 87%) of doctors stated that STI testing was an important part of healthcare. However, less than a third (29%, 95% CI 27% to 31%) would perform an STI test if the patients asked. Barriers for performing STI testing included lack of training, concerns about reimbursement, concerns about damage to clinics' reputations and the stigma against key populations. Respondents who reported that they would perform an STI test were likely to be younger, received a bachelor degree or higher, received specific training in STIs, believed that STI test was an important part of healthcare or had resources to perform STI testing. Conclusions There is potential for improving STI management in China through upskilling the primary care workforce in CHCs. Specific training in STIs is needed, and other structural, logistical and attitudinal barriers are needed to be addressed.

AB - Background China has strengthened its primary care workforce and implemented a wide network of community health centres (CHCs). However, STI testing and management are not currently included in the 'Essential Package of Primary Health Care in China'. Legislation change to encourage STI service delivery would be important, but it is also critical to determine if there are also provider-related opportunities and barriers for implementing effective STI programmes through CHCs if future legislation were to change. Methods A national representative survey was conducted between September and December 2015 in a stratified random sample of 180 CHCs based in 20 cities in China. Primary care practitioners (PCPs) provided information on current experiences of STI testing as well as the barriers and facilitators for STI testing in CHCs. Multivariate logistic regression was conducted to determine factors associated with PCPs performing STI testing. Results 3580 out of 4146 (86%) invited PCPs from 158 CHCs completed the survey. The majority (85%, 95% CI 84% to 87%) of doctors stated that STI testing was an important part of healthcare. However, less than a third (29%, 95% CI 27% to 31%) would perform an STI test if the patients asked. Barriers for performing STI testing included lack of training, concerns about reimbursement, concerns about damage to clinics' reputations and the stigma against key populations. Respondents who reported that they would perform an STI test were likely to be younger, received a bachelor degree or higher, received specific training in STIs, believed that STI test was an important part of healthcare or had resources to perform STI testing. Conclusions There is potential for improving STI management in China through upskilling the primary care workforce in CHCs. Specific training in STIs is needed, and other structural, logistical and attitudinal barriers are needed to be addressed.

KW - China

KW - community services

KW - health services research

KW - Infection control

KW - primary care

KW - service delivery

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U2 - 10.1136/sextrans-2017-053196

DO - 10.1136/sextrans-2017-053196

M3 - Article

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SP - 566

EP - 571

JO - Sexually Transmitted Infections

JF - Sexually Transmitted Infections

SN - 1368-4973

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ER -