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

• Published in: Sexually transmitted diseases 2007-07, Vol.34 (7), p.S22-S30
• Main Authors: HOSSAIN, MAZEDA, BROUTET, NATHALIE, HAWKES, SARAH
• Format: Article
• Language: English
• Subjects: Comparative analysis; Congenital syphilis; Disease prevention; Elimination; Female; Global Health; Goals; Health care policy; Health Planning; Health Policy; Human immunodeficiency virus; Humans; Infant, Newborn; Maternal-Child Health Centers - organization & administration; Partnerships; Policy Making; Pregnancy; Pregnant women; Review; Syphilis; Syphilis, Congenital - epidemiology; Syphilis, Congenital - etiology; Syphilis, Congenital - prevention & control; Treponema pallidum; World Health Organization
• ISSN: 0148-5717; 1537-4521
• DOI: 10.1097/01.olq.0000261049.84824.40

Background and Objectives: 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. Study Design: 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. Results: 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. Conclusions: The elimination of CS can be achieved through the implementation of a series of proven measures but requires technical