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