5 Clinical and Support Services
Table 5.1 Clinical service models
Type of clinic |
Description |
Advantages |
Disadvantages |
Stand-alone( often NGOrun) |
|
• Technically efficient |
|
Outreach clinics( often NGOrun)
Preferred service providers( private)
Governmentowned clinics
• Full-time services in fixed location; ideal where there is a high concentration of sex workers( e. g. red-light district) and a large number of sex workers(> 500)
• Dedicated staff required
• Satellite clinics( fixed location), mobile vans, health camps
• Part-time clinics
• Operate at fixed time in fixed locations
• Ideal for reaching hardto-reach sex workers and for providing services to smaller numbers of sex workers
• Dedicated staff required
• Services provided by trained private providers identified by sex workers.
( It is essential that private practitioners be trained to provide effective STI services to sex workers based on national guidelines.)
• Government clinics, either stand-alone STI clinics or integrated with other services e. g. SRH, HIV, primary care
• Comprehensive services may be provided; mix of clinical and educational interventions is possible
• Flexible to address needs of sex workers
• Possibility of linking to safe space( drop-in centre)
• Involvement of sex workers is possible
• May reach hard-to-reach sex workers
• Acceptable and accessible
• Cost-effective if accessing hard-to-reach sex workers
• Acceptable to sex workers
• May be cost-effective for a small number of sex workers
• Sustainable
• Sustainable
• Provision of technically efficient services if staff are well trained and facilities are available
• May be costly if few sex workers access the clinic
• Possibility of stigma associated with clinic
• May be difficult to sustain
• Provision of comprehensive services for sex workers may not be possible
• Quality of services may be variable
• Comprehensive services may not be provided( e. g. educational and counselling services)
• Quality monitoring and reporting may not be possible
• May not be acceptable and accessible to sex workers; strong links with NGO- and community-led outreach services are needed
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