Scaling up antenatal syphilis screening in Mozambique: transforming policy to action.
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.
Gloyd
Stephen
S
Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, Washington, USA. gloyd@u.washington.edu
Montoya
Pablo
P
Floriano
Florencia
F
Chadreque
Mariaana Correia
MC
Pfeiffer
James
J
Gimbel-Sherr
Kenneth
K
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