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Table 2 Thematic framework, personnel interviewed and key findings of investigation of syphilis POC testing policy in Ghana

From: Rollout of rapid point of care tests for antenatal syphilis screening in Ghana: healthcare provider perspectives and experiences

Themes and sub-themes

Personnel interviewed

Key findings

1. Uptake and successes

 • Syphilis testing for pregnant women

Facility in-charges, midwives and laboratory technologists

Almost all facilities were performing syphilis tests for pregnant women either at the antenatal clinic or laboratory

Two facilities could not start syphilis testing due to lack of/expired test kits

 • Successes

Facility in-charges, midwives, pharmacists and laboratory technologists

Decentralisation of syphilis testing

Free syphilis testing and treatment for pregnant women

2. Staff training and facility level preparedness for rollout of treponemal POCTs

 • Awareness of policy on antenatal syphilis screening

Facility in-charges, medical officers and midwives

All respondents aware of the need to screen all pregnant women for syphilis

 • Knowledge of consequences of untreated maternal syphilis

Facility in-charges, medical officers and midwives

Almost all staff knew of an adverse pregnancy outcome due to maternal syphilis

Considered knowledge of the consequences of untreated maternal syphilis to be essential in counselling

 • Training and retraining in the use of treponemal POCTs

Facility in-charges, midwives, laboratory technologists and STI coordinator

Midwives trained in all facilities

Issues with quality of training (compared to HIV training): duration, content, practical demonstration and interpretation of test results

Lack of standard operating procedures

No re-retraining/refresher training after the initial training

 • Antenatal syphilis screening, treatment and referral guidelines

Facility in-charges, midwives, lab technologists and STI coordinator

No guidelines for antenatal syphilis screening

Syphilis treatment protocols available in only two facilities

No referral guidelines for syphilis screening and treatment

Screening and treatment guidelines/protocols for other maternal and newborn interventions displayed at vantage points in facilities

No partner notification cards/slips for STIs (including syphilis & HIV)

3. Staff experiences and challenges

 • Maternal syphilis as a component of health education during pregnancy

Midwives

All but one facility discussed maternal syphilis during health education sessions for pregnant women

 • Experience of performing HIV and syphilis tests together

Midwives

Easier and time saving for healthcare providers

Good counselling required for a clear understanding and interpretation of HIV and syphilis test results

Convenient for pregnant women

 • Challenges

All

Stockouts of syphilis test kits and benzathine penicillin

Inadequate staff/work overload

Poor documentation of syphilis test results and treatment

Lack of supervision and quality checks

  1. ANC - Antenatal care; POCT – Point of care test; STI - Sexually transmitted infection