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Despite the availability of rapid diagnostic tests and inexpensive treatment  for pregnant women, maternal-child syphilis transmission remains a leading cause of perinatal morbidity and mortality in developing countries. In Haiti, more than 3000 babies are born with congenital syphilis annually. <jats:italic>Methods and Findings<\/jats:italic>. From 2007 to 2011, we used a sequential time series, multi-intervention study design in fourteen clinics throughout Haiti to improve syphilis testing and treatment in pregnancy. The two primary interventions were the introduction of a rapid point-of-care syphilis test and systems strengthening based on quality improvement (QI) methods. Syphilis testing increased from 91.5% prediagnostic test to 95.9% after (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mi>P<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:math>) and further increased to 96.8% (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mi>P<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:math>) after the QI intervention. Despite high rates of testing across all time periods, syphilis treatment lagged behind and only increased from 70.3% to 74.7% after the introduction of rapid tests (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\"><mml:mi>P<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.27<\/mml:mn><\/mml:math>), but it improved significantly from 70.2% to 84.3% (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\"><mml:mi>P<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:math>) after the systems strengthening QI intervention. <jats:italic>Conclusion<\/jats:italic>. Both point-of-care diagnostic testing and health systems-based quality improvement interventions can improve the delivery of specific evidence-based healthcare interventions to prevent congenital syphilis at scale in Haiti. Improved treatment rates for syphilis were seen only after the use of systems-based quality improvement approaches.<\/jats:p>","DOI":"10.1155\/2013\/247901","type":"journal-article","created":{"date-parts":[[2013,12,22]],"date-time":"2013-12-22T21:00:54Z","timestamp":1387746054000},"page":"1-7","source":"Crossref","is-referenced-by-count":5,"title":["Rapid-Testing Technology and Systems Improvement for the Elimination of Congenital Syphilis in Haiti: Overcoming the \u201cTechnology to Systems Gap\u201d"],"prefix":"10.1155","volume":"2013","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3240-1680","authenticated-orcid":true,"given":"Linda","family":"Severe","sequence":"first","affiliation":[{"name":"GHESKIO Centres, Port-Au-Prince, Haiti"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daphne","family":"Benoit","sequence":"additional","affiliation":[{"name":"GHESKIO Centres, Port-Au-Prince, Haiti"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi K.","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Public Health, Weill Cornell Medical Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean W.","family":"Pape","sequence":"additional","affiliation":[{"name":"GHESKIO Centres, Port-Au-Prince, Haiti"},{"name":"Global Health Center, Weill Cornell Medical Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosanna W.","family":"Peeling","sequence":"additional","affiliation":[{"name":"London School of Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel W.","family":"Fitzgerald","sequence":"additional","affiliation":[{"name":"GHESKIO Centres, Port-Au-Prince, Haiti"},{"name":"Global Health Center, Weill Cornell Medical Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kedar S.","family":"Mate","sequence":"additional","affiliation":[{"name":"Department of Medicine, Weill Cornell Medical Center, 525 East 68th Street, P.O. 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