Acceptability and technical problems of the female condom amongst commercial sex workers in a rural district of Malawi.

摘要

A study was conducted among commercial sex workers (CSWs) in rural southern Malawi, in order to podoconiosis outreach sites are located. The variance on these proportions was high, so the difference between proportions of patients accessing treatment in outreach woredas compared to non-outreach woredas did not reach statistical significance. Our data are insufficient to prove a causal relationship between the existence of podoconiosis outreach sites and proportion of patients able to access treatment, but suggest that a more detailed investigation into this would be fruitful. Government health facilities are located in every woreda, suggesting that even though such facilities are available, they may be little used by people with podoconiosis. The reasons for this need to be explored, but may include lack of expertise in managing podoconiosis, attitude of staff to people with podoconiosis or cost of treatment prescribed. There was a similar pattern of a higher proportion of patients using footwear in woredas in which specific podoconiosis outreach sites are located. Footwear is a major form of both prevention and treatment advocated by the MFA and others. For most of the population, footwear is unaffordable, so podoconiosis patients are trained to make durable but low cost footwear (materials are subsidized by the MFA) for other patients, and to encourage their use by non-sufferers too.