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Table 2 Barriers and facilitators for same-day screening and treatment in antenatal care to prevent congenital syphilis

From: Barriers and facilitators to the implementation of antenatal syphilis screening and treatment for the prevention of congenital syphilis in the Democratic Republic of Congo and Zambia: results of qualitative formative research

Levels Barriers Facilitators
System level • Structural constraints (beyond the health care system)
• Fragmentation of the health system
• Existence of ANC guidelines in conflict with proposed intervention
• Poor accessibility of clinics (geographical and functional)
• Staff and product shortages at the PCCs
• Existence of national guidelines for ANC best practice recommendations (including testing and counselling at first visit)
• Public health initiatives to improve quality of care
Health providers’ level • Lack of knowledge and training about evolving best practices
• Reservations regarding same-day screening and treatment
• Recognition of importance of early treatment
• Willingness to improve methods for testing
Pregnant women level • Late enrollment in ANC
• Lack of knowledge about syphilis, consequences and treatment
• Stigma
• Recognized importance of ANC visits
• Health education provided at the clinics
• Acceptance of same-day screening and treatment at first ANC visit