STI Services Module Guide
The Sexually Transmitted Infection (STI) Services module in the Health Services Report captures service data related to STI screening, diagnosis, and treatment on a monthly basis. All service data are disaggregated by Channel: Franchise Facility, Service Delivery Partner, or PSI Direct Service Provision. For franchise facilities and service delivery partners, only services that meet PSI’s criteria for service delivery through partners can be reported. For detailed definitions of these channels and channel types, please click here: https://helppsi.freshdesk.com/support/solutions/articles/14000014984-common-data-element-definitions.
Why collect these data?
The tables request data that comprise common indicators for STI programming. This data is useful for a variety of programmatic and reporting applications:
Internally , these data will provide important information about global trends in service delivery, informing quality assurance measures and facilitating identification of platform-to-platform technical assistance opportunities for programmatic improvement. These data are also key inputs for proposals, further ensuring STI and HIV program advancement through continued and additional funding.
Externally , these data allow PSI to leverage its network to contribute to global discussions about STI management and integration of STI services with HIV and FP health services. This global engagement is critical to ongoing advocacy with donors.
Impact Estimation (e.g. DALYs averted): In each table, we have noted where data will be used to estimate impact.
The table below outlines the module’s data tables and their corresponding data elements:
Section 1: STI Screening & Diagnosis | Data Elements |
| Table 1: Clients screened and diagnosed by channel | Syndromic screening Lab-confirmed diagnosis |
Section 2: STI Treatment | Data Elements |
| Table 1: STI treatment by delivery channel | STI treatment services provided by type Urethral discharge, men Urethral discharge, women Vaginitis Cervicitis Non-herpetic genital ulcer (Syphilis, Chancroid) Genital herpes Inguinal bubo (Chancroid, Lymphogranuloma, Venerium) Lower abdominal pain |
Section 3: Client Age | Data Elements |
| Table 1: Clients screened by age and gender Table 2: Clients treated by age and gender | Clients screened by age and gender Clients treated by age and gender |
Each table and data element are described in further detail below.
Section 1: STI Screening & Diagnosis | Data Elements |
| Table 1: Clients screened and diagnosed by channel | Syndromic screening Lab-confirmed diagnosis |
| Data Element: Syndromic screening |
| Purpose: This data element is measuring the total number of clients screened via syndromic screening (based on clinical manifestation of symptoms) for STIs other than HIV. |
| Precise Definitions: Syndromic screening: The identification of consistent groups of symptoms and easily recognized signs (syndromes) of STIs upon examination of a client (WHO). Syndromes include urethritis, cervicitis, genital ulcers, vaginitis, lower abdominal pain, and inguinal bubo. This data element captures individuals who presented with:
|
| Unit of Measure: Number of clients screened |
| Disaggregated by: Channel (franchise, service delivery partner, PSI direct service provision) |
| Justification/Management Utility: Information about the number of individuals who present with different STI syndromes will provide PSI with a global picture of the burden of STIs managed by our programs. This is crucial to better capture the scale of our STI work which, to date, has often been unacknowledged. This will support information sharing with donors who increasingly see this as a key component of standard FP and HIV service delivery. |
| Indicator: lab-confirmed diagnosis |
| Purpose: This data element is measuring the total number of clients screened and diagnosed via a lab-confirmed diagnosis for a STI other than HIV, disaggregated by channel |
| Precise Definitions: Lab-confirmed diagnosis: The etiological diagnosis of STIs using laboratory tests or microscopy to identify the causative agent (WHO). STIs are often asymptomatic and some symptoms may be indicative of several different STIs. This is the most accurate method of making a diagnosis. This data element captures the number of individuals who were diagnosed with chlamydia, gonorrhea, syphilis, or another STI based on confirmed laboratory examination results. There are three different types of diagnostic tests:
If your program screens for symptoms and then confirms with laboratory tests, the case should only be reported as lab-confirmed. For a detailed definition of “channel” see the common data elements definition page |
| Unit of Measure: Number of clients screened and diagnosed via lab-confirmed diagnosis |
| Disaggregated by: Channel (franchise, service delivery partner, PSI direct service provision) |
| Justification/Management Utility: Information about the number of individuals who have a lab-confirmed STI will provide PSI with a complete global picture of the burden of STIs managed by our programs. This is crucial to better capturing the scale of our STI work which, to date, has often been unacknowledged. This will support information sharing with donors who increasingly see this as a key component of standard FP and HIV service delivery. |
Section 2: STI Treatment | Data Elements |
| Table 1: STI treatment by delivery channel | STI treatment services provided by type Urethral discharge, men Urethral discharge, women Vaginitis Cervicitis Non-herpetic genital ulcer Genital herpes Inguinal bubo Lower abdominal pain |
| Indicator: STI treatment services by type |
| Purpose: This data element is measuring the total number of treatment services provided by type of STI and channel |
| Precise Definitions: Syndromic management relies on the patient’s symptoms and clinical signs for identification of the specific syndrome; then all causes of the syndrome are treated. Treatment is defined by the WHO guidelines for each syndrome, including medication and counseling. Treatment following lab-confirmed diagnosis should also be reported under the corresponding syndrome. Urethral discharge in men can be a sign of an infection, called “urethritis.” Most often, this type of infection is the result of an STI. The same bacteria and protozoa that cause certain STIs such as gonorrhea, chlamydia, and trichomoniasis also cause urethritis. Urethral discharge in women could be a sign of Chlamydia, gonorrhea, or trichomonas. Other causes such as irritation caused by tight clothes should not be included. Vaginitis is an inflammation of the vagina that can result in discharge, itching and pain. Vaginitis could be a sign of trichomoniasis, which is transmitted by sexual intercourse, or Candidiasis. Cervicitis is an inflammation of the cervix, the lower, narrow end of the uterus that opens into the vagina. Among the signs and symptoms women sometimes notice are bleeding between menstrual periods and changes in vaginal discharge. Often, cervicitis results from a sexually transmitted infection, such as chlamydia or gonorrhea. Non-herpetic genital ulcer (Syphilis, Chancroid): Genital sores can appear as bumps or sores that may be red, itchy, or painful. This data element records clients treated for genital sores indicative of syphilis or chancroid. Genital herpes: Symptoms of herpetic genital ulcer are indicative of primary or recurrent herpes simplex virus. This data element records clients who present with one or multiple genital sore(s) and are treated for genital herpes. Inguinal buboes are localized enlargements of the lymph nodes in the groin area, which are painful and may be fluctuant. They are frequently associated with lymphogranuloma venereum and chancroid. Lower abdomen pain could be associated with Pelvic Inflammatory Disease (PID) caused by gonorrhea and/or chlamydia. Please see the WHO training modules for additional details on Syndromic Management: http://www.who.int/reproductivehealth/publications/rtis/9789241593407/en/ WHO guidelines on treatment of gonorrhea: http://www.who.int/reproductivehealth/publications/rtis/gonorrhoea-treatment-guidelines/en/ WHO guidelines on treatment of Chlamydia: http://www.who.int/reproductivehealth/publications/rtis/chlamydia-treatment-guidelines/en/ For a detailed definition of “channel” and “product type” see the common data elements definition page |
| Unit of Measure: Number of clients served |
| Disaggregated by: STI type (Urethral discharge, vaginitis, cervicitis, non-herpetic genital ulcer, genital herpes, inguinal bubo, lower abdominal pain) Channel (franchise, service delivery partner, PSI direct service provision) |
| Justification/Management Utility: STI services are rapidly expanding in the PSI network because the service is a key component for both quality FP and HIV programs. Understanding the use and extent of syndromic management in the PSI network will inform Global Services technical assistance, including support to country programs able to shift to lab confirmed diagnosis as the gold standard in STI management. Additionally, because STI services are growing, it is important for PSI to have a global picture of where and through what channel type services are being delivered. This will support information sharing with donors who increasingly see this as a key component of standard FP and HIV service delivery. Information about the number of individuals who present with different STI syndromes will provide PSI with a global picture of the burden of STIs managed by our programs. This is crucial to better capture the scale of our STI work which, to date, has often been unacknowledged. Treatment services is used to calculate DALYs averted. |
Section 3: Client Age | Data Elements |
| Table 1: Clients screened by age and gender Table 2: Clients treated by age and gender | Clients screened by age and gender Clients treated by age and gender |
| Indicator: Clients screened by age and gender |
| Purpose: This data element is measuring the total number of clients screened, disaggregated by age and gender |
| Precise Definitions: Individuals receiving STI services will fall under one of the following 3 category options: Syndromic screening: The identification of consistent groups of symptoms and easily recognized signs (syndromes) of STIs upon examination of a client (WHO). Syndromes include urethritis, cervicitis, genital ulcers, vaginitis, lower abdominal pain, and inguinal bubo. Lab-confirmed diagnosis: The etiological diagnosis of STIs using laboratory tests or microscopy to identify the causative agent (WHO). STIs are often asymptomatic and some symptoms may be indicative of several different STIs. This is the most accurate method of making a diagnosis. Unknown: The method of STI identification is unspecified or unknown. |
| Unit of Measure: Number of clients screened |
| Disaggregated by: Age ( <15, 15-19, 20-24, 25-49, 50+, or unknown) Gender (male, female, transgender) |
| Justification/Management Utility: STI services are rapidly expanding in the PSI network because the service is a key component for both quality FP and HIV programs. Understanding the use and extent of syndromic management in the PSI network will inform Global Services technical assistance, including support to country programs able to shift to lab confirmed diagnosis as the gold standard in STI management. Additionally, because STI services are growing, it is important for PSI to have a global picture of where and through what channel type services are being delivered. This will support information sharing with donors who increasingly see this as a key component of standard FP and HIV service delivery. Gender and age are critical correlates of STI infection risk that will be captured to inform programmatic improvement. |
| Indicator: Clients treated by age and gender |
| Purpose: This data element is measuring the total number of clients treated, disaggregated by age and gender. |
| Precise Definitions: Syndromic management relies on the patient’s symptoms and clinical signs for identification of the specific syndrome; then all causes of the syndrome are treated. Treatment is defined by the WHO guidelines for each syndrome, including medication and counseling, or the appropriate treatment for the lab-confirmed diagnosis. |
| Unit of Measure: Number of clients treated |
| Disaggregated by: Age ( <15, 15-19, 20-24, 25-49, 50+, or unknown) Gender (male, female, transgender) |
| Justification/Management Utility: STI services are rapidly expanding in the PSI network because the service is a key component for both quality FP and HIV programs. Understanding the use and extent of syndromic management in the PSI network will inform Global Services technical assistance, including support to country programs able to shift to lab confirmed diagnosis as the gold standard in STI management. Additionally, because STI services are growing, it is important for PSI to have a global picture of where and through what channel type services are being delivered. This will support information sharing with donors who increasingly see this as a key component of standard FP and HIV service delivery. Gender and age are critical correlates of STI infection risk that will be captured to inform programmatic improvement. |