Introducing onsite antenatal syphilis screening in Burkina Faso: implementation and evaluation of a feasibility intervention tailored to a local context View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2017-05-30

AUTHORS

Fadima Yaya Bocoum, Grissoum Tarnagda, Fabrice Bationo, Justin R. Savadogo, Sarata Nacro, Séni Kouanda, Christina Zarowsky

ABSTRACT

BackgroundAlthough the advantages of introducing point of care testing for syphilis in antenatal care (ANC) are well documented, there is little evidence on how to address structural issues within health systems. A better understanding of how these interventions work in a range of settings and contexts is needed in order to overcome bottlenecks at health system level. To better understand the relationships between implementation and context we developed and implemented an intervention focused on integrating a rapid screening test for syphilis in ANC services in rural primary health care facilities in Burkina Faso. This manuscript describes the intervention and reports on feasibility and acceptability of the intervention, the facilitators and barriers to the implementation of this intervention and the likelihood that point of care test for syphilis will become routinely incorporated in practice.MethodsIn Kaya Health and Demographic Surveillance System (Kaya HDSS), all 7 primary healthcare facilities were selected for intervention in 2013. A participatory approach was used to design and implement an antenatal syphilis screening intervention. The Normalization Process Model (NPM) proposed by May et al. was adapted in order to identify barriers and facilitators and to explore the likelihood to become routinely incorporated in practice. Registers, Observations (n = 14 ANC 1) of interactions between patients and health workers during ANC and interviews with health workers (n = 14) were our data sources.ResultsAn intervention that included onsite training, provision of supplies and medicines, quality control and supervision was implemented in 7 health facilities in 2013. Rapid syphilis test and treatment were delivered during ANC within the examination room with no specific additional mechanism regarding staff organization. The perceived barriers were lack of training of all staff, workload, stock-outs of consumables and lack of motivation of staff. Key facilitators included political environment, ease of use of test and acceptability to pregnant women.ConclusionsOnsite testing for antenatal syphilis is a feasible and acceptable intervention in ANC at primary health facility in Burkina Faso. The point-of care test for syphilis is more likely to be acceptable by health workers as routine service and incorporated as a normal practice.Trial registrationThe study was retrospectively registered on ClinicalTrials.gov under the Trial Registration Number NCT03156751. More... »

PAGES

378

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12913-017-2325-x

DOI

http://dx.doi.org/10.1186/s12913-017-2325-x

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1085704939

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28558812


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38 Burkina Faso
39 Demographic Surveillance System
40 Faso
41 Kaya Health
42 May et al
43 Register
44 Trial registrationThe study
45 acceptability
46 acceptable intervention
47 additional mechanism
48 advantages
49 al
50 antenatal care
51 antenatal syphilis
52 approach
53 barriers
54 better understanding
55 bottleneck
56 care
57 care facilities
58 care test
59 care testing
60 consumables
61 context
62 control
63 data sources
64 ease
65 ease of use
66 environment
67 et al
68 evaluation
69 evidence
70 examination room
71 facilitators
72 facilities
73 feasibility
74 health
75 health care facilities
76 health facilities
77 health system
78 health system level
79 health workers
80 healthcare facilities
81 implementation
82 interaction
83 intervention
84 interviews
85 issues
86 key facilitators
87 lack
88 lack of motivation
89 lack of training
90 levels
91 likelihood
92 little evidence
93 local context
94 manuscript
95 mechanism
96 medicine
97 model
98 motivation
99 normal practice
100 normalization process model
101 observations
102 observations of interactions
103 onsite training
104 order
105 organization
106 participatory approach
107 patients
108 point
109 political environment
110 practice
111 pregnant women
112 primary health care facilities
113 primary health facilities
114 primary healthcare facilities
115 process model
116 provision
117 provision of supplies
118 quality control
119 range
120 range of settings
121 rapid screening test
122 rapid syphilis tests
123 relationship
124 report
125 room
126 routine services
127 rural primary health care facilities
128 screening test
129 services
130 setting
131 source
132 staff
133 staff organization
134 structural issues
135 study
136 supervision
137 supply
138 surveillance system
139 syphilis
140 syphilis tests
141 system
142 system level
143 test
144 testing
145 training
146 treatment
147 understanding
148 use
149 women
150 workers
151 workload
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