title: Scaling up antenatal syphilis screening in Mozambique: transforming policy to action.
abstract: OBJECTIVE
  This paper examines the decade-long scale-up process of antenatal syphilis screening through Mozambique's National Health System.
  
  
  OBJECTIVE
  The primary goal is to provide lessons learned in the provision of integrated antenatal care resource-poor settings and identify key challenges to successful scale-up.
  
  
  METHODS
  We documented health systems activities associated with improvements in the proportion of women tested, treated, and partners treated for syphilis.
  
  
  RESULTS
  The proportion of women in antenatal visit screened for syphilis in the two target provinces has risen from 5% in 1992 to between 60% and 95% consistently since 1999. This success required multiple levels of health system strengthening.
  
  
  CONCLUSIONS
  The Mozambique experience shows that key elements to effective antenatal syphilis screening include adequate workforce, facilities, coherent systems of care, community involvement, donor management, advocacy, and leadership.
authors.affiliation: Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, Washington, USA. gloyd@u.washington.edu
authors.forename: Stephen
authors.initials: S
authors.lastname: Gloyd
authors.forename: Pablo
authors.initials: P
authors.lastname: Montoya
authors.forename: Florencia
authors.initials: F
authors.lastname: Floriano
authors.forename: Mariaana Correia
authors.initials: MC
authors.lastname: Chadreque
authors.forename: James
authors.initials: J
authors.lastname: Pfeiffer
authors.forename: Kenneth
authors.initials: K
authors.lastname: Gimbel-Sherr
mesh_terms: D005260:Female; D006291:Health Policy; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D008403:Mass Screening / Q000706:statistics & numerical data*; D008430:Maternal-Child Health Centers / Q000458:organization & administration*; D009073:Mozambique; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control; D013587:Syphilis / Q000175:diagnosis* / Q000188:drug therapy / Q000517:prevention & control / Q000635:transmission; D013590:Syphilis, Congenital / Q000517:prevention & control* / Q000635:transmission