Barriers to antenatal syphilis screening in Burkina Faso.
Barriers to antenatal syphilis screening in Burkina Faso.
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DOI：
10.11694/pamj.supp.2014.17.1.3423
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发表时间：
2014-01-01
期刊：
影响因子：
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通讯作者：
Zarowsky, Christina
中科院分区：
文献类型：
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作者：
Bocoum, Fadima Yaya;Kouanda, Seni;Zarowsky, Christina
导言：尽管在治疗和管理方面取得了进展，但梅毒仍然是布基纳法索的一个主要公共卫生问题。妊娠期梅毒对母亲和胎儿的健康构成重大风险，也增加了艾滋病毒传播的风险。尽管有潜在的好处，但在许多撒哈拉以南非洲国家，产前梅毒筛查的实施往往很差。本研究的目的是确定和了解影响布基纳法索孕妇梅毒筛查卫生系统绩效的障碍。方法：我们在布基纳法索的卡亚卫生区进行了深入的访谈和观察。有目的地选择参与者，以捕捉具有不同角色和责任的不同参与者的一系列视角。对保健提供者、地区管理人员、设施管理人员、传统治疗师、孕妇、社区卫生工作者和非政府组织管理人员进行了75次访谈。使用NVivo软件将访谈转录并组织成代码和类别。结果：参与者确定了卫生服务提供者和社区层面的多重障碍。提供者层面的主要障碍包括服务分散、沟通不良、处方动机低以及对梅毒负担的认识低。检测费用、到实验室的距离和缺乏对梅毒的知识被确定为社区一级的障碍。结论：该研究突出了距离、检测费用和梅毒知识等障碍。引入梅毒护理点检测可以作为提高产前梅毒筛查覆盖率的切入点。
INTRODUCTION: Despite advances in treatment and management, syphilis remains a major public health problem in Burkina Faso. Syphilis in pregnancy poses major health risks for the mother and the fetus and also increases the risk for HIV transmission. Despite its potential benefits, antenatal syphilis screening is often poorly implemented in many sub-Saharan African countries. The purpose of the study is to identify and understand barriers affecting health system performance for syphilis screening among pregnant women in Burkina Faso.METHODS: We conducted in-depth interviews and observations in the Kaya health district, Burkina Faso. Participants were purposively selected to capture a range of perspectives across different actors with different roles and responsibilities. Seventy-five interviews were conducted with health providers, district managers, facility managers, traditional healers, pregnant women, community health workers, and Non-Governmental Organizations (NGO) managers. Interviews were transcribed and organized into codes and categories using NVivo software.RESULTS: Participants identified multiple barriers at health providers and community levels. Key barriers at provider level included fragmentation of services, poor communication, low motivation for prescription, and low awareness of syphilis burden. Cost of testing, distance to laboratory and lack of knowledge about syphilis were identified as barriers at community level.CONCLUSION: The study highlights barriers such as distance, cost of testing, and knowledge about syphilis. The introduction of point of care testing for syphilis could be an entry point for improving coverage of antenatal syphilis screening.