{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T08:10:31Z","timestamp":1792656631835,"version":"4.5.0"},"reference-count":32,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2015,4,29]],"date-time":"2015-04-29T00:00:00Z","timestamp":1430265600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2015,4,29]],"date-time":"2015-04-29T00:00:00Z","timestamp":1430265600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2015,4,21]],"date-time":"2015-04-21T00:00:00Z","timestamp":1429574400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":125,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004963","name":"Seventh Framework Programme","doi-asserted-by":"publisher","award":["265827"],"award-info":[{"award-number":["265827"]}],"id":[{"id":"10.13039\/501100004963","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004348","name":"Stockholms L\u00e4ns Landsting","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004348","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004047","name":"Karolinska Institutet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004963","name":"European Union Seventh Framework Programme","doi-asserted-by":"publisher","award":["265827"],"award-info":[{"award-number":["265827"]}],"id":[{"id":"10.13039\/501100004963","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004348","name":"Stockholm County Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004348","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004047","name":"Karolinska Institutet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004963","name":"Seventh Framework Programme","doi-asserted-by":"publisher","award":["265827"],"award-info":[{"award-number":["265827"]}],"id":[{"id":"10.13039\/501100004963","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004348","name":"Stockholms L\u00e4ns Landsting","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004348","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004047","name":"Karolinska Institutet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["ijgo.org","clinicalkey.jp","clinicalkey.com","clinicalkey.es","clinicalkey.com.au","clinicalkey.fr","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To identify and compare implementation bottlenecks for effective coverage of screening for syphilis, HIV, and anemia in antenatal care in rural Tanzania and Uganda; and explore the underlying determinants and perceived solutions to overcome these bottlenecks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this multiple case study, we analyzed data collected as part of the Expanded Quality Management Using Information Power (EQUIP) project between November 2011 and April 2014. Indicators from household interviews (n = 4415 mothers) and health facility surveys (n = 122) were linked to estimate coverage in stages of implementation between which bottlenecks can be identified. Key informant interviews (n = 15) were conducted to explore underlying determinants and analyzed using a framework approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Large differences in implementation were found within and between countries. Availability and effective coverage was significantly lower for all tests in Uganda compared with Tanzania. Syphilis screening had the lowest availability and effective coverage in both countries. The main implementation bottleneck was poor availability of tests and equipment. Key informant interviews validated these findings and perceived solutions included the need for improved procurement at the central level.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings reinforce essential screening as a missed opportunity, caused by a lack of integration of funding and support for comprehensive antenatal care programs.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.ijgo.2015.04.017","type":"journal-article","created":{"date-parts":[[2015,5,2]],"date-time":"2015-05-02T16:58:14Z","timestamp":1430585894000},"update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":41,"title":["Bottlenecks in the implementation of essential screening tests in antenatal care: Syphilis, HIV, and anemia testing in rural Tanzania and Uganda"],"prefix":"10.1002","volume":"130","author":[{"given":"Ulrika","family":"Baker","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Okuga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Waiswa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatuma","family":"Manzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Peterson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Hanson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,4,29]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60792-3"},{"key":"e_1_2_7_3_2","volume-title":"The Partnership for Maternal, Newborn, and Child Health (PMNCH). Essential interventions, commodities and guidelines. A global review of key interventions related to reproductive, maternal, newborn and child health","author":"World Health Organization","year":"2011"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.12.107623"},{"key":"e_1_2_7_5_2","volume-title":"Antiretroviral drugs for treating pregnant women and preventing HIV infections in infants: recommendations for a public health approach","author":"World Health Organization","year":"2010"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(14)70227-X"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-3016.2001.0150s1001.x"},{"key":"e_1_2_7_8_2","volume-title":"Focused antenatal care, malaria and syphilis in pregnancy. Orientation package for service providers","author":"Ministry of Health Tanzania","year":"2002"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3156.2005.01473.x"},{"key":"e_1_2_7_10_2","unstructured":"Medical Stores Department Tanzania www.msd.or.tz. Accessed February 2015"},{"key":"e_1_2_7_11_2","volume-title":"Health Sector Strategic Plan III 2010\/11\u20101014\/15","author":"Government of Uganda","year":"2010"},{"key":"e_1_2_7_12_2","volume-title":"Integrated health services \u2013 what and why? Technical brief No. 1, May 2008","author":"WHO Working Group on Service Delivery","year":"2008"},{"key":"e_1_2_7_13_2","volume-title":"Rapid assessment tool for sexual and reproductive health and HIV linkages. A generic guide","author":"United Nations Population Fund (UNFPA)","year":"2009"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e318267bc94"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/1756-0500-7-746"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000000042"},{"key":"e_1_2_7_17_2","volume-title":"Case study research: design and methods","author":"Yin R.","year":"2014"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-9-41"},{"key":"e_1_2_7_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-014-0112-1"},{"key":"e_1_2_7_20_2","volume-title":"Tanzania HIV\/AIDS and malaria indicator survey 2011\u201012","author":"Tanzania Commission for AIDS (TACAIDS)","year":"2013"},{"key":"e_1_2_7_21_2","volume-title":"Uganda AIDS indicator survey 2011","author":"Ministry of Health","year":"2012"},{"issue":"2","key":"e_1_2_7_22_2","first-page":"295","article-title":"Health\u2010Service coverage and its evaluation","volume":"56","author":"Tanahashi T.","year":"1978","journal-title":"Bull World Health Organ"},{"key":"e_1_2_7_23_2","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.14.141879"},{"key":"e_1_2_7_24_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-13-117"},{"key":"e_1_2_7_25_2","unstructured":"Ifakara Health Institute Tanzania service availability and readiness assessmenthttp:\/\/spd.ihi.or.tz\/sara\/. Accessed Nov 2014"},{"key":"e_1_2_7_26_2","volume-title":"Health statistics and information systems. Uganda service availability and readiness assessment 2013 Summary report: Key findings in figures","author":"World Health Organization","year":"2013"},{"key":"e_1_2_7_27_2","unstructured":"World Health Organization Sexually transmitted infections. Percentage of antenatal care attendees tested for syphilis at first visithttp:\/\/gamapserver.who.int\/gho\/interactive_charts\/sti\/anc_syphilis_test\/atlas.html. Accessed February 2015"},{"key":"e_1_2_7_28_2","volume-title":"The global elimination of congenital syphilis: rationale and strategy for action","author":"World Health Organization","year":"2007"},{"key":"e_1_2_7_29_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0087510"},{"key":"e_1_2_7_30_2","unstructured":"Save the Children Maternal Health Task Force Integration of maternal and newborn health care: meeting report. 2014. Healthy Newborn Networkhttp:\/\/www.healthynewbornnetwork.org\/resource\/integration\u2010maternal\u2010and\u2010newborn\u2010health\u2010care\u2010meeting\u2010report. Accessed December 2014"},{"key":"e_1_2_7_31_2","volume-title":"Ministry of Health and Social Welfare, mainland Tanzania National guidelines for the management of HIV and AIDS","author":"The United Republic of Tanzania","year":"2012"},{"key":"e_1_2_7_32_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0056713"},{"key":"e_1_2_7_33_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0060694"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1016%2Fj.ijgo.2015.04.017","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1016%2Fj.ijgo.2015.04.017","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/api.elsevier.com\/content\/article\/PII:S0020729215002143?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/api.elsevier.com\/content\/article\/PII:S0020729215002143?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.ijgo.2015.04.017","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T15:24:43Z","timestamp":1695569083000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1016\/j.ijgo.2015.04.017"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,4,29]]},"references-count":32,"journal-issue":{"issue":"S1","published-print":{"date-parts":[[2015,6]]}},"alternative-id":["10.1016\/j.ijgo.2015.04.017"],"URL":"https:\/\/doi.org\/10.1016\/j.ijgo.2015.04.017","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,4,29]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Bottlenecks in the implementation of essential screening tests in antenatal care: Syphilis, HIV, and anemia testing in rural Tanzania and Uganda","name":"articletitle","label":"Article Title"},{"value":"International Journal of Gynecology & Obstetrics","name":"journaltitle","label":"Journal Title"},{"value":"http:\/\/dx.doi.org\/10.1016\/j.ijgo.2015.04.017","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Copyright \u00a9 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd.","name":"copyright","label":"Copyright"}]}}