Botswana antenatal STI screening draws provider support but faces systemic barriers

In interviews with 15 healthcare workers, all participants favoured testing for specific infections, while also warning that the antenatal and STI services they already work in face shortages of electricity, space, supplies, staff and equipment maintenance. The study examines providers’ perspectives in Gaborone; it does not measure whether antenatal STI screening improves clinical outcomes. Researchers conducted 15 in-depth interviews between April and October 2023 with healthcare workers providing antenatal or STI care in Gaborone, Botswana.

The interviews were audio-recorded, transcribed and coded using NVivo, with the researchers then identifying emergent themes. The participants supported diagnostic screening during pregnancy for Chlamydia trachomatis and Neisseria gonorrhoeae . One expressed the view that “if there are new technologies, let’s move forward.” Their responses indicate that the proposed screening was viewed as a potentially acceptable way to identify infections that might otherwise be missed, but acceptance was conditional on the health system having the resources needed to deliver it reliably.

One provider said the system “sometimes it collapses—the supplies run off,” while another referred to times when even treatment was unavailable. These accounts suggest that adding diagnostic screening would occur within a service already managing shortages of essential supplies, rather than in an otherwise fully resourced system. Participants said they were already overwhelmed by their workloads, raising questions about whether existing personnel could absorb additional screening responsibilities.

Others described equipment that stopped working after it had been installed, indicating that maintenance was not consistently available. The providers also identified staff training, health education for patients and faster tests as factors that could facilitate implementation. Overall, the findings show strong professional support for antenatal diagnostic STI screening in Botswana, alongside clear warnings that electricity, physical space, stock levels, staffing and equipment maintenance would shape whether the approach could be delivered.

Because the research was limited to interviews with 15 providers in one city, it does not establish the feasibility of screening across Botswana or demonstrate effects on treatment uptake, maternal health or infant health. It instead offers a qualitative assessment of potential implementers’ views ahead of roll-out, identifying the health-system conditions that those providers considered essential.

Subject of Research: Healthcare providers’ perspectives on implementing antenatal diagnostic STI screening in Botswana

Article Title: “Provided power is there, it will be a good initiative”: healthcare provider perspectives on diagnostic screening for curable STIs during pregnancy in Botswana

Article References: Mussa, A., Russell, J. C., Hansman, E., Babalola, C. M., Bame, B., Ndlovu, N., Tamuthiba, L., Klausner, J. D., Morroni, C., & Wynn, A. (2026). “Provided power is there, it will be a good initiative”: healthcare provider perspectives on diagnostic screening for curable STIs during pregnancy in Botswana. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15608-6

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15608-6

Keywords: Botswana, antenatal care, chlamydia, gonorrhoea, diagnostic screening, sexually transmitted infections, healthcare providers, health systems, qualitative research, Provided, power, there