{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:26:22Z","timestamp":1785421582708,"version":"3.56.0"},"reference-count":28,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background:\u00a0Early enrolment for antenatal care (ANC) is an important strategy in improving perinatal and maternal outcomes. Treatable conditions in pregnancy, such as anaemia, human immunodeficiency virus (HIV), and syphilis can be identified and treated in the early antenatal period, thereby improving maternal and foetal outcomes. However, late enrolment for ANC is a concerning problem, especially in high HIV-prevalence settings, such as South Africa. The aim of this study was to evaluate screening of pregnant women fro HIV, syphilis and anaemia on the first antenatal visit at a midwife-run obstetric unit in KwaZulu-Natal, South Africa.\nMethods:\u00a0This audit of maternity case records at a primary health care facility in South Africa focuses on the screening for treatable conditions (i.e. HIV, syphilis and anaemia) among women presenting for their first antenatal visit.\nResults:\u00a0Data were extracted from the files of 400 (87.7%) of the 456 women who enroled for ANC between July and December 2023. There was good coverage for screening of HIV, syphilis and anaemia. The prevalence of anaemia among women enrolling for ANC was 25% (n\u00a0= 99), 40.8% (n\u00a0= 100) of participants were HIV positive (n\u00a0= 100) and 2.5% (n\u00a0= 10) tested positive for syphilis. Of concern, less than 20% (n\u00a0= 72) enrolled for ANC in the first trimester, thereby limiting the effectiveness of ANC interventions.\nConclusion:\u00a0The low uptake of early ANC services is of concern, especially in high HIV-prevalence settings.\nContribution:\u00a0Training of primary health care providers in point-of-care ultrasounds may improve community awareness of the benefits of early ANC. Further investigation is required into the knowledge and perceptions of women regarding ANC services.<\/jats:p>","DOI":"10.4102\/safp.v68i1.6261","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T13:20:59Z","timestamp":1775654459000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A retrospective review of screening for HIV, syphilis and anaemia on first antenatal care visits at a midwife-run obstetric unit in South Africa"],"prefix":"10.4102","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2698-950X","authenticated-orcid":false,"given":"Keshena","family":"Naidoo","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03r1jm528","id-type":"ROR","asserted-by":"publisher"}],"name":"Nelson Mandela University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2699-1001","authenticated-orcid":false,"given":"Monjural","family":"Hoque","sequence":"additional","affiliation":[{"name":"KwaDabeka Community Health Centre, eThekwini Health District, KwaZulu-Natal Department of Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5951-9566","authenticated-orcid":false,"given":"Maariyah","family":"Hoque","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0400yw722","id-type":"ROR","asserted-by":"publisher"}],"name":"South African College of Applied Psychology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4182-1027","authenticated-orcid":false,"given":"Somaya","family":"Buckus","sequence":"additional","affiliation":[{"name":"KwaDabeka Community Health Centre, eThekwini Health District, KwaZulu-Natal Department of Health"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2026,4,9]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Lee BX, Kjaerulf F, Turner S, et al. Transforming our world: Implementing the 2030 agenda through sustainable development goal indicators. J Public Health Policy. 2016;37(Suppl. 1):13\u201331. https:\/\/doi.org\/10.1057\/s41271-016-0002-7","DOI":"10.1057\/s41271-016-0002-7"},{"key":"ref1","unstructured":"WHO. WHO recommendations on antenatal care for a positive pregnancy experience. Geneva: World Health Organization; 2016."},{"key":"ref2","unstructured":"World Health Organization. Trends in maternal mortality 2000 to 2017: Estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division: Executive summary. Contract No.: WHO\/RHR\/19.23. Geneva: World Health Organization; 2019."},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Ward ZJ, Atun R, King G, Dmello BS, Goldie SJ. Global maternal mortality projections by urban\/rural location and education level: A simulation-based analysis. EClinicalMedicine. 2024;72:102653. https:\/\/doi.org\/10.1016\/j.eclinm.2024.102653","DOI":"10.1016\/j.eclinm.2024.102653"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Warri D, George A. Perceptions of pregnant women of reasons for late initiation of antenatal care: A qualitative interview study. BMC Pregnancy Childbirth. 2020;20(1):70. https:\/\/doi.org\/10.1186\/s12884-020-2746-0","DOI":"10.1186\/s12884-020-2746-0"},{"key":"ref5","unstructured":"World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience: Summary: Highlights and key messages from the World Health Organization\u2019s 2016 global recommendations for routine antenatal care. Geneva: World Health Organization; 2018."},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Carroli G, Rooney C, Villar J. How effective is antenatal care in preventing maternal mortality and serious morbidity? An overview of the evidence. Paediatr Perinat Epidemiol. 2001;15(Suppl. 1):1\u201342. https:\/\/doi.org\/10.1046\/j.1365-3016.2001.00001.x","DOI":"10.1046\/j.1365-3016.2001.00001.x"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Schmidt CN, Butrick E, Musange S, Mulindahabi N, Walker D. Towards stronger antenatal care: Understanding predictors of late presentation to antenatal services and implications for obstetric risk management in Rwanda. PLoS One. 2021;16(8):e0256415. https:\/\/doi.org\/10.1371\/journal.pone.0256415","DOI":"10.1371\/journal.pone.0256415"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Kuhnt J, Vollmer S. Antenatal care services and its implications for vital and health outcomes of children: Evidence from 193 surveys in 69 low-income and middle-income countries. BMJ Open. 2017;7(11):e017122. https:\/\/doi.org\/10.1136\/bmjopen-2017-017122","DOI":"10.1136\/bmjopen-2017-017122"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Habte A, Tamene A, Melis T. Compliance towards WHO recommendations on antenatal care for a positive pregnancy experience: Timeliness and adequacy of antenatal care visit in sub-Saharan African countries: Evidence from the most recent standard Demographic Health Survey data. PLos One. 2024;19(1):e0294981. https:\/\/doi.org\/10.1371\/journal.pone.0294981","DOI":"10.1371\/journal.pone.0294981"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Alem AZ, Yeshaw Y, Liyew AM, et al. Timely initiation of antenatal care and its associated factors among pregnant women in sub-Saharan Africa: A multicountry analysis of Demographic and Health Surveys. PLoS One. 2022;17(1):e0262411. https:\/\/doi.org\/10.1371\/journal.pone.0262411","DOI":"10.1371\/journal.pone.0262411"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Boah M, Issah A-N, Yeboah D, Kpordoxah MR, Sira J. Association between compliance with the new WHO-recommended frequency and timing of antenatal care contacts and receiving quality antenatal care in Cameroon. Sage Open. 2022;12(3):21582440221117807. https:\/\/doi.org\/10.1177\/21582440221117807","DOI":"10.1177\/21582440221117807"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"Nyando M, Makombe D, Mboma A, Mwakilama E, Nyirenda L. Perceptions of pregnant women on antenatal care visit during their first trimester at area 25 health center in Lilongwe, Malawi \u2013 A qualitative study. BMC Womens Health. 2023;23(1):646. https:\/\/doi.org\/10.1186\/s12905-023-02800-7","DOI":"10.1186\/s12905-023-02800-7"},{"key":"ref13","unstructured":"Haffejee F, Ghuman S, Reddy P, et al. Timing of first antenatal care attendance and associated factors among pregnant women in an obstetric health facility in eThekwini district, KwaZulu-Natal Province, South Africa. Afr J Phys Activ Health Sci. 2018;24(2):181\u2013192."},{"key":"ref14","doi-asserted-by":"crossref","unstructured":"Owigho O, Isara A. Women\u2019s perception of quality and utilization of antenatal care and delivery services in Oshimili South Local Government Area of Delta State, Nigeria. J Commun Med Prim Health Care. 2022;34(1):81\u201398. https:\/\/doi.org\/10.4314\/jcmphc.v34i1.6","DOI":"10.4314\/jcmphc.v34i1.6"},{"key":"ref15","doi-asserted-by":"crossref","unstructured":"Hlongwane TM, Bozkurt B, Barreix MC, et al. Implementing antenatal care recommendations, South Africa. Bull World Health Organ. 2021;99(3):220\u2013227. https:\/\/doi.org\/10.2471\/BLT.20.278945","DOI":"10.2471\/BLT.20.278945"},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"Ndlovu N, Gray A, Blose N, Mokganya M. Health and related indicators, 2023. S Afr Health Rev. 2023;2023(1):172\u2013239. https:\/\/doi.org\/10.61473\/001c.122768","DOI":"10.61473\/001c.122768"},{"key":"ref17","unstructured":"National Department of Health. Saving mothers. Executive summary 2020\u20132024. Pretoria: South African National Department of Health; 2024."},{"key":"ref18","doi-asserted-by":"crossref","unstructured":"Patience NT, Sibiya MN, Gwele NS. Evidence of application of the basic antenatal care principles of good care and guidelines in pregnant women\u2019s antenatal care records. Afr J Prim Health Care Fam Med. 2016;8(2):1\u20136. https:\/\/doi.org\/10.4102\/phcfm.v8i2.1016","DOI":"10.4102\/phcfm.v8i2.1016"},{"key":"ref19","doi-asserted-by":"crossref","unstructured":"Whelan R, Schaeffer L, Olson I, et al. Measurement of symphysis fundal height for gestational age estimation in low-to-middle-income countries: A systematic review and meta-analysis. PLoS One. 2022;17(8):e0272718. https:\/\/doi.org\/10.1371\/journal.pone.0272718","DOI":"10.1371\/journal.pone.0272718"},{"key":"ref20","doi-asserted-by":"crossref","unstructured":"Okedo-Alex IN, Akamike IC, Ezeanosike OB, Uneke CJ. Determinants of antenatal care utilisation in sub-Saharan Africa: A systematic review. BMJ Open. 2019;9(10):e031890. https:\/\/doi.org\/10.1136\/bmjopen-2019-031890","DOI":"10.1136\/bmjopen-2019-031890"},{"key":"ref21","doi-asserted-by":"crossref","unstructured":"Ngomane S, Mulaudzi FM. Indigenous beliefs and practices that influence the delayed attendance of antenatal clinics by women in the Bohlabelo district in Limpopo, South Africa. Midwifery. 2012;28(1):30\u201338. https:\/\/doi.org\/10.1016\/j.midw.2010.11.002","DOI":"10.1016\/j.midw.2010.11.002"},{"key":"ref22","unstructured":"World Health Organization. WHO antenatal care recommendations for a positive pregnancy experience. Maternal and fetal assessment update: Imaging ultrasound before 24 weeks of pregnancy. Geneva: World Health Organization; 2022."},{"key":"ref23","doi-asserted-by":"crossref","unstructured":"Abrokwa SK, Ruby LC, Heuvelings CC, B\u00e9lard S. Task shifting for point of care ultrasound in primary healthcare in low- and middle-income countries \u2013 A systematic review. eClinicalMedicine. 2022;45:101333. https:\/\/doi.org\/10.1016\/j.eclinm.2022.101333","DOI":"10.1016\/j.eclinm.2022.101333"},{"key":"ref24","doi-asserted-by":"crossref","unstructured":"Kawooya MG, Nathan RO, Swanson J, et al. Impact of introducing routine antenatal ultrasound services on reproductive health indicators in Mpigi District, Central Uganda. Ultrasound Q. 2015;31(4):285\u2013289. https:\/\/doi.org\/10.1097\/RUQ.0000000000000142","DOI":"10.1097\/RUQ.0000000000000142"},{"key":"ref25","doi-asserted-by":"crossref","unstructured":"Mashamba T, Eyo A, Masilela S, Busakwe A, Towobola O. Limited obstetrics ultrasound in primary healthcare delivery; outputs for strategic considerations: A review of pilot study in Gauteng Province, South Africa. J Gynecol Obstet. 2022;10(2):52\u201359. https:\/\/doi.org\/10.11648\/j.jgo.20221002.11","DOI":"10.11648\/j.jgo.20221002.11"},{"key":"ref26","doi-asserted-by":"crossref","unstructured":"Bidner A, Bezak E, Parange N. Evaluation of antenatal Point-of-Care Ultrasound (PoCUS) training: A systematic review. Med Educ Online. 2022;27(1):2041366. https:\/\/doi.org\/10.1080\/10872981.2022.2041366","DOI":"10.1080\/10872981.2022.2041366"},{"key":"ref27","doi-asserted-by":"crossref","unstructured":"Woldesenbet S, Cheyip M, Lombard C, et al. Progress towards the UNAIDS 95-95-95 targets among pregnant women in South Africa: Results from the 2017 and 2019 national Antenatal HIV Sentinel Surveys. PLoS One. 2022;17(7):e0271564. https:\/\/doi.org\/10.1371\/journal.pone.0271564","DOI":"10.1371\/journal.pone.0271564"}],"container-title":["South African Family Practice"],"original-title":[],"link":[{"URL":"https:\/\/safpj.co.za\/index.php\/safpj\/article\/view\/6261\/10400","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T13:21:08Z","timestamp":1775654468000},"score":1,"resource":{"primary":{"URL":"https:\/\/safpj.co.za\/index.php\/safpj\/article\/view\/6261"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,9]]},"references-count":28,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,1]]}},"URL":"https:\/\/doi.org\/10.4102\/safp.v68i1.6261","relation":{},"ISSN":["2078-6190","2078-6204"],"issn-type":[{"value":"2078-6190","type":"print"},{"value":"2078-6204","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,9]]},"article-number":"a6261"}}