Barriers to Routine Antenatal Syphilis Screening in Uganda: Provider Perspectives and Practices.

IF 2.1 Q1 NURSING
Global Qualitative Nursing Research Pub Date : 2025-10-02 eCollection Date: 2025-01-01 DOI:10.1177/23333936251375457
Natalie Saham, Amanda P Miller, Stephen Mugamba, Taylor Thomas, Bashir Magada, Adriane Wynn, William Ddaaki, Emmanuel Kyasanku, Robert Bulamba, Vitalis O Olwa, James Nkale, Godfrey Kigozi, Fred Nalugoda, Grace N Kigozi, Alex Daama, Gertrude Nakigozi, Jennifer A Wagman
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引用次数: 0

Abstract

Congenital syphilis is preventable through early detection and treatment during pregnancy. Although global syphilis rates have declined, the prevalence of undiagnosed and untreated infections remains high in low- and middle-income countries. In Uganda, national clinical guidelines recommend syphilis screening and treatment at the first antenatal care (ANC) visit, yet coverage remains suboptimal, contributing to ongoing perinatal transmission. As part of a multiple-method research project, this qualitative study explored provider perspectives on barriers to antenatal syphilis screening and treatment. We conducted in-depth interviews with 20 ANC providers at six public health facilities in two districts serving diverse communities. Using a descriptive qualitative approach and thematic analysis, we identified four interrelated barriers to effective service delivery: (1) stockouts of test kits and benzathine penicillin that disrupt care; (2) limited access to formal training and continuing education, reducing provider confidence in diagnosis and treatment; (3) misalignment between clinical guidelines and routine practice, leading to missed screening opportunities; and (4) low male partner engagement, increasing risk of reinfection. Addressing these barriers through health systems strengthening-including improved supply chain monitoring, universal provider training, supportive supervision, and community-informed strategies for partner engagement-is critical to reducing perinatal syphilis transmission and advancing Uganda's progress toward congenital syphilis elimination.

乌干达常规产前梅毒筛查的障碍:提供者的观点和做法。
先天性梅毒可以通过怀孕期间的早期发现和治疗来预防。尽管全球梅毒发病率有所下降,但在低收入和中等收入国家,未确诊和未经治疗的感染流行率仍然很高。在乌干达,国家临床指南建议在第一次产前检查(ANC)时进行梅毒筛查和治疗,但覆盖率仍然不够理想,导致围产期传播持续存在。作为多方法研究项目的一部分,本定性研究探讨了提供者对产前梅毒筛查和治疗障碍的看法。我们对两个地区为不同社区服务的六个公共卫生机构的20名ANC提供者进行了深入访谈。使用描述性定性方法和专题分析,我们确定了有效提供服务的四个相互关联的障碍:(1)检测试剂盒和苄星青霉素的库存扰乱了护理;(2)获得正规培训和继续教育的机会有限,降低了提供者对诊断和治疗的信心;(3)临床指南与常规实践不一致,导致错过筛查机会;(4)男性伴侣参与度低,再感染风险增加。通过加强卫生系统来解决这些障碍,包括改进供应链监测、普及提供者培训、支持性监督和促进合作伙伴参与的社区知情战略,对于减少围产期梅毒传播和推动乌干达在消除先天性梅毒方面取得进展至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.90
自引率
5.90%
发文量
41
审稿时长
12 weeks
期刊介绍: Global Qualitative Nursing Research (GQNR) is a ground breaking, international, peer-reviewed, open-access journal focusing on qualitative research in fields relevant to nursing and other health professionals world-wide. The journal specializes in topics related to nursing practice, responses to health and illness, health promotion, and health care delivery. GQNR will publish research articles using qualitative methods and qualitatively-driven mixed-method designs as well as meta-syntheses and articles focused on methodological development. Special sections include Ethics, Methodological Development, Advancing Theory/Metasynthesis, Establishing Evidence, and Application to Practice.
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