1. Overview of the project Title:Addressing Social, Cultural and Historical Factors Limiting the Contribution of Medical Laboratory services to antenatal care in West Africa (SociaLab). What is your project about? To identify social, cultural and historical barriers to the utilization of antenatal care test results in West Africa Via two components : anthropology and biomedical science Start and end dates: November 2012-November 2015

2. Policy Relevant Questions Is there a gap between policy and practice in terms of ANC laboratory test utilization in Senegal? What are the reasons for this gap and how can they be addressed? Is laboratory capable and are human resources for laboratory sufficiently empowered to deliver ANC tests in Senegal? Do historical factors influence the current policy in terms of ANC testing in West Africa and how can this be addressed?

3. Progress At what stage is the research process?  data collection:Completed at the level of health facility and the community Ongoing at the level of policy makers  Data analysis:Ongoing  Data dissemination: starting up  winding-up:not started, Data dissemination is under the responsibility of researchers themselves, in Senegal.

4. Stakeholders Engagement Main stakeholdersAt what stages of the project have these stakeholders been involved? Division of Reproductive Health  Kick-off meeting (nov 2012)  Midterm meeting (june 2014)  After the midterm meeting, with presentation of preliminary findings (Oct 2014) Health Workers: Midwives and Laboratory Staff  Kick-off meeting  Data collection  Midterm meeting

5. Stakeholder engagement strategies What strategies has your project used to engage your key stakeholders?  Invitation at dissemination/discussion meetings,  Workshops in health facilities (part of data collection of anthropologist)  Special meeting already held in the direction of Reproductive Health with the Director and all the staff, with presentation of preliminary results (Oct 2014)

6. Key messages What research findings/implications is your team advancing for stakeholder actions? 1.Although ANC coverage is high in Senegal, ANC screening test are largely underused, creating a missed opportunity to detect serious medical conditions. 2.Clear guidelines on minimum recommended ANC test package need to be developed/adjusted by Direction of Reproductive Health, in collaboration wit the Directorate of Laboratory and the HIV programme. These guidelines should be disseminated adequately. 3.ANC laboratory test should be made more affordable

7. Key messages 4.Adequate utilization of ANC testing is not only the problem for the laboratory and is not only a question of technical capacity, 1.ANC services need strengthening in terms of reinforcing HR in number, knowledge of the national guidelines and in the delivery of informed ANC services to the clients, 2.Laboratory services are properly equipped with skilled HR but need to implement user friendly practices and 5.ANC rapid and integrated testing is a solution to increase access to ANC screening in health post BUT quality assurance procedure need to be implemented under the supervision of the laboratory.

8. KT Products What KT products/activities has your project generated or accomplished so far? – Dissemination meetings (3) – Scientific abstracts: Global Heath Symposium (1) and ASLM Conference (2) – One paper in preparation – KTNet blogs (1), Newsletters (2) What additional KT products and activities does your coalition plan to undertake during 2015 and beyond? – Sharing at meetings (formal and informal), – Conferences, KTNet blogs, – Newsletters, – Newspaper and peer-reviewed articles, – Reports

9. Key research findings What key research findings support these messages? 1-More than 50% of women attending the lab for ANC screening do not receive a complete set of ANC test results. This goes up to 69% in women receiving ANC in Health Posts 2-ANC tests feature in various documents, but do not match: National guidelines for ANC, ANC register for the division of reproductive health, Women's consultation booklets. The national guidelines are not known by most of midwives.

10. Key research findings What key research findings support these messages? 3- ANC test panel cost between 8,000 - 12,500 CFA (±12.30 - 20€), i.e 2.5 days work for someone with a regular salary; 51% of women who came for tests to the lab indicated that price of tests is an issue. 4-45% of midwives do not request a complete set of test even in health facilities hosting a laboratory. Midwives are gate keepers to the laboratory, 5-72% of laboratory have inconvenient opening hours and/or long turn around time for test results, obliging pregnant women to come back another day.

11. Challenges and opportunities What KT related challenges has your project encountered? The lack of platform for discussion in various department of the MoH. The language Media are not available unless paid How has your project over come these challenges? Most challenges are not resolved Better implication of the division of communication of the MoH (SNEIPS) What opportunities does your project envisage to overcome these challenges? A budget and a plan for media

12. Support What support will your project require to produce and execute the planned KT products and activities? Educate the stakeholders Resources to: – Engage the media – Produce video material – Support the organization of meetings with various stakeholders – Travel to conferences and relevant meetings

13. Thank you