Health-worker barriers to syphilis screening in pregnant women in Bolivia's Los Andes Network/Barreras del personal de salud Para el tamizale de sifilis en mujeres Andes Bolivia

Objective. Identify health-worker barriers that keep pregnant women who receive prenatal care from being screened for syphilis (Los Andes Health Network, Bolivia). Methods. Semi-structured interviews were done with 46 health care providers and 249 clinical health records of pregnant women were analyzed in eight public health facilities in the Los Andes Network. Results. Health-worker barriers to syphilis screening in pregnant women included personnel's lack of time to raise awareness about the benefit of syphilis screening; some mentioned that syphilis tests should only be done in facilities that attend deliveries and have a laboratory; lack of communication between clinicians and laboratory personnel; and problems with provision of supplies and reagents. The clinical record review found that only 55.4% of clinical health records contained syphilis laboratory results and only 37.4% of perinatal clinical histories had records of laboratory results. The interviews found that providers believe that syphilis screening is done in 100% of pregnant women receiving prenatal care. Conclusion. Syphilis screening is not being done according to Bolivia's strategy for the elimination of congenital syphilis, and is not done on more than half of pregnant women in prenatal care with perinatal clinical history records. This is not perceived by health professionals and can become a barrier to syphilis screening in pregnant women. Keywords Mass screening; syphilis; prenatal care; pregnancy; Bolivia. Objetivo. Identificar barreras del personal de salud por las cuales las embarazadas que asisten al control prenatal no se realizan el tamizaje de sifilis (Red de Salud Los Andes, Bolivia). Metodos. Se realizaron 46 entrevistas semiestructuradas a proveedores de salud y se analizaron los registros de 249 expedientes clinicos de embarazadas de ocho establecimientos publicos de salud de la Red Los Andes. Resultados. Entre las barreras del personal de salud para el tamizaje de sifilis en embarazadas de la Red Los embarazadas se identificaron el tiempo insuficiente del personal para sensibilizar sobre el beneficio del tamizaje de sifilis, algunos mencionaron que las pruebas de sifilis se deberian hacer solo en centros donde atienden partos y tienen laboratorio, la poca comunicacion entre el personal de la consulta medica y laboratorio, asi como tambien problemas de abastecimiento de suministros y reactivos. En la revision de expedientes clinicos se observo que 55,4% contaba con los re