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

作者：Natalie Saham, Amanda P. Miller, Stephen Mugamba, T. Thomas, Bashir Magada, Adriane Wynn, William Ddaaki, Emmanuel Kyasanku, Robert Bulamba, Vitalis Ofumbi Olwa, James Nkale, Godfrey Kigozi, Fred Nalugoda, Grace N. Kigozi, Alex Daama, Gertrude Nakigozi, Jennifer A. Wagman · 发表于：Global Qualitative Nursing Research · 年份：2025 · DOI：10.1177/23333936251375457 · 被引用次数：3 · 研究领域：Syphilis Diagnosis and Treatment、Global Maternal and Child Health、HIV/AIDS Research and Interventions

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 s...