The World Health Organization has determined that screening and treating all pregnant women for syphilis is cost-effective if at least 0.1 percent of pregnant women have syphilis. To address the high rate of syphilis among pregnant women (6.5–7.3 percent), the Nairobi City Council (NCC) introduced maternal syphilis screening and management in its antenatal clinics in 1989. However, its centralized approach—taking collected blood samples to a central laboratory for testing—was inefficient. Therefore, in 1992 the NCC tested a decentralized approach in 9 of its 54 antenatal clinics, which featured on-site rapid testing of women by clinic staff and same-day treatment of positive women by nurses, and promotion of notification and presumptive treatment of the positive women’s partners. This approach was deemed successful and was replicated in five additional clinics. In 2000, the Population Council conducted a case study to assess the effectiveness, cost, and sustainability of the decentralized syphilis screening program after eight years of operation. As noted in this brief, providing antenatal clients with same-day screening and treatment for syphilis resulted in higher treatment rates for positive clients and their partners at an affordable cost.
"Kenya: On-site antenatal syphilis services are cost-effective," FRONTIERS OR Summary. Washington, DC: Population Council, 2001.
Frontiers in Reproductive Health