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

BACKGROUND: Effective implementation of rapid point of care tests (POCTs) for antenatal syphilis screening especially in settings where antenatal care attendance is high, can significantly increase screening coverage and treatment uptake. The operational challenges of introducing rapid syphilis POCT...

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Autores principales: Dassah, Edward Tieru, Adu-Sarkodie, Yaw, Mayaud, Philippe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5819248/
https://www.ncbi.nlm.nih.gov/pubmed/29458363
http://dx.doi.org/10.1186/s12913-018-2935-y
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author Dassah, Edward Tieru
Adu-Sarkodie, Yaw
Mayaud, Philippe
author_facet Dassah, Edward Tieru
Adu-Sarkodie, Yaw
Mayaud, Philippe
author_sort Dassah, Edward Tieru
collection PubMed
description BACKGROUND: Effective implementation of rapid point of care tests (POCTs) for antenatal syphilis screening especially in settings where antenatal care attendance is high, can significantly increase screening coverage and treatment uptake. The operational challenges of introducing rapid syphilis POCTs at scale needs to be investigated. This study explores healthcare providers’ experiences and challenges in antenatal syphilis screening following the national rollout of rapid syphilis POCTs in Ghana. METHODS: Prior to the main study, we undertook a desk review of key syphilis policy documents, and conducted key stakeholder interviews and a baseline survey of syphilis screening practices. Antenatal syphilis screening had been poorly implemented mainly due to inadequate technical and logistic support, and lack of monitoring and supervision. For the main research, semi-structured interviews were conducted with 51 purposively selected healthcare staff involved in antenatal syphilis screening in 15 health facilities in three regions, representative of all levels of healthcare in Ghana and two regional programme coordinators, at least four months after the rollout. The interviews were supplemented with an audit of the conduct of antenatal care, syphilis-related supplies and other maternal and newborn interventions. Qualitative data were coded and analysed using Nvivo software. RESULTS: Syphilis screening with rapid POCTs was integrated into antenatal care in almost all (13/15) the facilities surveyed. Testing and treatment were offered free of charge to pregnant women, their partners and babies. In most facilities, midwives were performing syphilis tests together with HIV tests. Operational challenges included: inadequate training and lack of refresher training, lack of clear testing guidelines, clear channels of communication, supervision, and guidance on treatment and referral procedures, frequent stockouts of, or expired test kits, staff overload, and poor documentation of test results and treatment. CONCLUSION: Although syphilis screening with rapid syphilis POCTs was integrated into antenatal care, key challenges, particularly around supply chain and supervision, need to be addressed to improve and sustain such a programme.
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spelling pubmed-58192482018-02-21 Rollout of rapid point of care tests for antenatal syphilis screening in Ghana: healthcare provider perspectives and experiences Dassah, Edward Tieru Adu-Sarkodie, Yaw Mayaud, Philippe BMC Health Serv Res Research Article BACKGROUND: Effective implementation of rapid point of care tests (POCTs) for antenatal syphilis screening especially in settings where antenatal care attendance is high, can significantly increase screening coverage and treatment uptake. The operational challenges of introducing rapid syphilis POCTs at scale needs to be investigated. This study explores healthcare providers’ experiences and challenges in antenatal syphilis screening following the national rollout of rapid syphilis POCTs in Ghana. METHODS: Prior to the main study, we undertook a desk review of key syphilis policy documents, and conducted key stakeholder interviews and a baseline survey of syphilis screening practices. Antenatal syphilis screening had been poorly implemented mainly due to inadequate technical and logistic support, and lack of monitoring and supervision. For the main research, semi-structured interviews were conducted with 51 purposively selected healthcare staff involved in antenatal syphilis screening in 15 health facilities in three regions, representative of all levels of healthcare in Ghana and two regional programme coordinators, at least four months after the rollout. The interviews were supplemented with an audit of the conduct of antenatal care, syphilis-related supplies and other maternal and newborn interventions. Qualitative data were coded and analysed using Nvivo software. RESULTS: Syphilis screening with rapid POCTs was integrated into antenatal care in almost all (13/15) the facilities surveyed. Testing and treatment were offered free of charge to pregnant women, their partners and babies. In most facilities, midwives were performing syphilis tests together with HIV tests. Operational challenges included: inadequate training and lack of refresher training, lack of clear testing guidelines, clear channels of communication, supervision, and guidance on treatment and referral procedures, frequent stockouts of, or expired test kits, staff overload, and poor documentation of test results and treatment. CONCLUSION: Although syphilis screening with rapid syphilis POCTs was integrated into antenatal care, key challenges, particularly around supply chain and supervision, need to be addressed to improve and sustain such a programme. BioMed Central 2018-02-20 /pmc/articles/PMC5819248/ /pubmed/29458363 http://dx.doi.org/10.1186/s12913-018-2935-y Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Dassah, Edward Tieru
Adu-Sarkodie, Yaw
Mayaud, Philippe
Rollout of rapid point of care tests for antenatal syphilis screening in Ghana: healthcare provider perspectives and experiences
title Rollout of rapid point of care tests for antenatal syphilis screening in Ghana: healthcare provider perspectives and experiences
title_full Rollout of rapid point of care tests for antenatal syphilis screening in Ghana: healthcare provider perspectives and experiences
title_fullStr Rollout of rapid point of care tests for antenatal syphilis screening in Ghana: healthcare provider perspectives and experiences
title_full_unstemmed Rollout of rapid point of care tests for antenatal syphilis screening in Ghana: healthcare provider perspectives and experiences
title_short Rollout of rapid point of care tests for antenatal syphilis screening in Ghana: healthcare provider perspectives and experiences
title_sort rollout of rapid point of care tests for antenatal syphilis screening in ghana: healthcare provider perspectives and experiences
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5819248/
https://www.ncbi.nlm.nih.gov/pubmed/29458363
http://dx.doi.org/10.1186/s12913-018-2935-y
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