ArticlePloS one2020
A study to better understand under-utilization of laboratory tests for antenatal care in Senegal.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 8 citations in OpenAlex.
- HIV prevalence in pregnant women attending antenatal consultations in Senegal in 2021.BMC research notes · 2025Article
- "We have theoretical knowledge, but these are not things we do regularly": District hospital's healthcare workers' experiences and perceptions on gestational diabetes mellitus screening in Tanzania.PLOS global public health · 2025Article
- Factors influencing late antenatal care of Muslim pregnant women: A predictive correlational study in Aceh, Indonesia.Belitung nursing journal · 2024Article
- More Than One-Third of Pregnant Women in Ethiopia Had Dropped Out From Their ANC Follow-Up: Evidence From the 2019 Ethiopia Mini Demographic and Health Survey.Frontiers in global women's health · 2022Article
- The Lancet Commission on diagnostics: transforming access to diagnostics.Lancet (London, England) · 2021Review
- An oral history of medical laboratory development in francophone West African countries.African journal of laboratory medicine · 2021Article
- Preparing national tiered laboratory systems and networks to advance diagnostics in Africa and meet the continent's health agenda: Insights into priority areas for improvement.African journal of laboratory medicine · 2020Article
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo better understand factors contributing to underutilization of laboratory services for health care delivery in sub-Saharan Africa, we conducted a study in Senegalese Antenatal Care clinics (ANC) and laboratories to determine the extent of underutilization, contributing factors, and bottlenecks in the cascade of care from first ANC visit, test uptake, to availability of test results and appropriate clinical management.
methodsAt 16 health facilities, pregnant women attending for their first ANC visit were consecutively recruited and information was prospectively collected on the request, execution, results and clinical management of seven nationally recommended laboratory screening tests for normal pregnancy: hemoglobin concentration (Hb), syphilis serology, HIV serology, determination of proteinuria (PU), determination of blood group and Rhesus factor, Emmel test to detect sickle cell disease, and glycaemia. Health facility staff were interviewed on human resource capacity, management of the ANC and the laboratory, and availability and use of guidelines.
resultsOf 1246 ANC attendants, 400 (32%) had complete results. Completeness varied between facilities from 0-99%. In multilevel logistic regression analysis of women nested in facilities, complete uptake was lower if women started ANC later in pregnancy; very low in rural ANC attendants who ever delivered compared to urban primigravidae (OR 0.064; 95%CI 0.00-0.52); and higher if the facility routinely recommended all seven tests. In the cascade from test request to clinical management, the most frequent bottleneck was non-execution of requested tests, while unavailability of results for executed test was uncommon (<2%). Overall, of 525 abnormal test results 97(18%) had a record of adequate clinical management.
conclusionOur study illustrates challenges to test uptake even when laboratory testing capacity is in place, with large differences between facilities, and underscores the importance of management, policy, and the importance of considering local context in order to improve service delivery to expectant mothers.
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