Scaling Up Antenatal Syphilis Screening in Mozambique: Transforming Policy to Action

Abstract

This paper examines the decade-long scale-up process of antenatal syphilis screening through Mozambique's National Health System. 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. We documented health systems activities associated with improvements in the proportion of women tested, treated, and partners treated for syphilis. 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. 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.