The Elimination of Congenital Syphilis: A Comparison of the Proposed World Health Organization Action Plan for the Elimination of Congenital Syphilis With Existing National Maternal and Congenital Syphilis Policies
Open Access
- 1 July 2007
- journal article
- research article
- Published by Wolters Kluwer Health in Sexually Transmitted Diseases
- Vol. 34 (7) , S22-S30
- https://doi.org/10.1097/01.olq.0000261049.84824.40
Abstract
Building upon a critical assessment of national policies, programs, and treatment options, the World Health Organization (WHO) recently developed an action plan for the elimination of congenital syphilis (CS). The objective of the review was to identify areas of commonality or divergence between the national strategies and the WHO plan, thereby helping to target the development of national-level policies in light of the forthcoming recommendations of the proposed WHO action plan to eliminate CS. The 4 strategic pillars of the proposed WHO action plan were used as a comparative framework to examine the policy, programmatic, and monitoring components of a sample of 14 existing national-level congenital or maternal control policies. The countries were chosen to represent a range of resource and prevalence levels. The majority of countries do not meet every element proposed in the WHO action plan. Political commitment (pillar 1) across the 14 countries is varied. CS elimination goals were rare but all had universal screening. Linkages to appropriate case management services were identified in 11 countries, although a national governing body was not generally evident. Efforts to increase and improve access to care (pillar 2) were noted in 8 countries with recommendations to ensure all pregnant women were screened and treated. Low-resource settings have formed international partnerships. Guidelines for the diagnosis and treatment of pregnant women and partners (pillar 3) found in high-resource settings were lacking in low-resource and high CS prevalence countries. Surveillance programs were active in 10 countries while comprehensive details on monitoring and evaluation (pillar 4) components including proxy CS indicators were unavailable for nearly all. The elimination of CS can be achieved through the implementation of a series of proven measures but requires technical support, funding, and a commitment among political forces, health officials, and the public to prevent and treat all CS cases and help countries reach their Millennium Development Goals. Stronger partnerships with clearly defined responsibilities should be developed among agencies responsible for national STI control, HIV/AIDS control, and Making Pregnancy Safer initiatives to ensure the universal coverage of CS control interventions.Keywords
This publication has 31 references indexed in Scilit:
- What's in a Name? Policy transfer in Mozambique: DOTS for tuberculosis and syndromic management for sexually transmitted infectionsJournal of Public Health Policy, 2004
- Thirteen years HIV-1 sentinel surveillance and indicators for behavioural change suggest impact of programme activities in south-west TanzaniaAIDS, 2004
- Is antenatal syphilis screening still cost effective in sub-Saharan AfricaSexually Transmitted Infections, 2003
- Avaliação da efetividade das campanhas para eliminação da sífilis congênita na redução da morbi-mortalidade perinatal: Município do Rio de Janeiro, 1999-2000Cadernos de Saude Publica, 2003
- Syphilis ControlSexually Transmitted Diseases, 1996
- Strategies for Syphilis Prevention in the 1990sSexually Transmitted Diseases, 1996
- Surveillance report: disease trends at New Zealand sexually transmitted disease clinics 1977-1993.Sexually Transmitted Infections, 1994
- Syphilis prevention in pregnancy: an opportunity to improve reproductive and child health in KenyaHealth Policy and Planning, 1993
- Pregnancy loss, infant death, and suffering: legacy of syphilis and gonorrhoea in Africa.Sexually Transmitted Infections, 1987
- Shadow on the Land: Syphilis.American Sociological Review, 1938