A retrospective review of screening for HIV, syphilis and anaemia on first antenatal care visits at a midwife-run obstetric unit in South Africa

Background: Early enrolment for antenatal care (ANC) is an important strategy in improving perinatal and maternal outcomes. Treatable conditions in pregnancy, such as anaemia, human immunodeficiency virus (HIV), and syphilis can be identified and treated in the early antenatal period, thereby improving maternal and foetal outcomes. However, late enrolment for ANC is a concerning problem, especially in high HIV-prevalence settings, such as South Africa. The aim of this study was to evaluate screening of pregnant women fro HIV, syphilis and anaemia on the first antenatal visit at a midwife-run obstetric unit in KwaZulu-Natal, South Africa. Methods: This audit of maternity case records at a primary health care facility in South Africa focuses on the screening for treatable conditions (i.e. HIV, syphilis and anaemia) among women presenting for their first antenatal visit. Results: Data were extracted from the files of 400 (87.7%) of the 456 women who enroled for ANC between July and December 2023. There was good coverage for screening of HIV, syphilis and anaemia. The prevalence of anaemia among women enrolling for ANC was 25% (n = 99), 40.8% (n = 100) of participants were HIV positive (n = 100) and 2.5% (n = 10) tested positive for syphilis. Of concern, less than 20% (n = 72) enrolled for ANC in the first trimester, thereby limiting the effectiveness of ANC interventions. Conclusion: The low uptake of early ANC services is of concern, especially in high HIV-prevalence settings. Contribution: Training of primary health care providers in point-of-care ultrasounds may improve community awareness of the benefits of early ANC. Further investigation is required into the knowledge and perceptions of women regarding ANC services.