Number and percentage of antenatal care attendees tested for syphilis at first antenatal care visit

Export Indicator

Number and percentage of antenatal care attendees tested for syphilis at first antenatal care visit
What it measures

Syphilis testing is part of the recommended basic antenatal services package, thus testing of antenatal care attendees for syphilis is also a marker of the quality of provision of essential antenatal care services.

Rationale

Evidence indicates that sexually transmitted infections, including syphilis, are associated with a higher risk of HIV infection. Syphilis testing and treatment can effectively prevent adverse pregnancy outcomes caused by maternal syphilis exposure, and is the core intervention in congenital syphilis control. Congenital syphilis can be prevented if all pregnant women are tested and treated sufficiently early in pregnancy, before poor outcomes in the fetus occur.

Numerator

Number of first visit antenatal care attendees in a year tested for syphilis

Denominator

Number of first visit antenatal care attendees in a year

Calculation

Numerator / Denominator

Method of measurement

Analysis of only first antenatal care visits is helpful in understanding quality of antenatal care syphilis testing programs since syphilis treatment must occur sufficiently early to avoid early fetal loss and stillbirth. Countries unable to distinguish first visit from subsequent visits can still report data on this indicator, but should clearly indicate this difference when reporting the data.

Disaggregation by age allows identification of differences in testing coverage for different sub-populations. Although difficult to do on a routine basis, disaggregation by trimester of pregnancy allows determination of what proportion of women are getting tested early enough in pregnancy to prevent poor pregnancy outcomes.

Measurement frequency

Periodic

Disaggregation
Explanation of the numerator
Explanation of the denominator
Strengths and weaknesses
Further information

Tool for surveillance monitoring and evaluation of congenital syphilis elimination efforts within existing systems, Initiative for the Global Elimination of Congenital Syphilis. Geneva: WHO. In development.

Indicator also described in WHO Global STI Strategy, WHO ECS Strategy, and WHO HIV Universal Access guidance documentation.