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Monetary incentives for provision of syphilis screening, Yunnan, China
Wanyue Zhang1, Hongbin Luo1, Yanling Ma1
1Yunnan Provincial Centre for Disease Control and Prevention, 158 Dongsi Road, Kunmin, China.
Problem:
Early detection of syphilis-infected people followed by effective treatment is essential for syphilis prevention and control.
Approach:
Starting in 2010 the local health authority in Yunnan province, China, developed a network of 670 service sites for syphilis testing, diagnosis and treatment or for testing-only with referral for further diagnosis and treatment. Point-of-care tests for syphilis and syphilis interventions were integrated into the existing human immunodeficiency virus (HIV) prevention and control programme. To improve the syphilis services, a pay-for-performance scheme was introduced in which providers were paid for testing and treating patients.
Local Setting:
Yunnan province is the region hardest hit by HIV infection and disproportionately burdened with syphilis cases in China.
Relevant Changes:
The proportion of attendees at voluntary counselling and testing clinics who were tested for syphilis increased from 46.2% (32 877/71 162) in 2010 to 98.2% (68 012/69 259) in 2015. Syphilis-infected cases treated with the recommended therapy increased from 26.6% (264/993) in 2010 to 82.5% (453/549) in 2015 at designated testing, diagnosis and treatment sites.
Lessons Learnt:
The strategy greatly increased the uptake of syphilis testing and treatment among people at risk. Introduction of point-of-care tests for syphilis increased coverage of the testing services. Introduction of a pay-for-performance scheme seemed to motivate health-care providers to undertake syphilis intervention services.
