Table 2.

Facilitators and barriers to newborn screening and enrollment into care

FacilitatorsBarriers
Newborn screening  
○ Government ownership and support in the form of policy formulation, funding, and import waivers
○ Involvement of the health care stakeholders in planning and workflow design30,32
○ Acceptability of NBS among stakeholders
○ Integration of NBS for SCD into existing services and programmes31,33  
Lack of government support and political will to implement existing policies on NBS
Lack of public awareness and low level of education among mothers30,31
Low accessibility to screening facilities31
Limited diagnostic laboratory materials supply and stock-outs31,32  
Enrollment and follow-up  
○ Existing well-resourced SCD clinics. Education of families using standardized text on the importance of follow-up30,31
○ Government ownership
○ Funding from industry partnerships and technical support
○ Collection of proper and adequate contact information for use in tracing patients should they not return to health facility35,37
○ Integration of NBS into maternal and child health programs in primary health care due to the cost of transport. Follow-up care should be designed for well babies instead of taking them into very busy pediatric clinics in tertiary health care centers. 
Denial of positive test results by parents because of apparently healthy babies within the first 6 months and stigma30,34
Low availability of, accessibility to, and affordability of comprehensive care services31
Unsuccessful tracking due to dynamics of mobile phone numbers (wrong or disconnected numbers)35
Delay in communicating test result and relocation of family after36  
FacilitatorsBarriers
Newborn screening  
○ Government ownership and support in the form of policy formulation, funding, and import waivers
○ Involvement of the health care stakeholders in planning and workflow design30,32
○ Acceptability of NBS among stakeholders
○ Integration of NBS for SCD into existing services and programmes31,33  
Lack of government support and political will to implement existing policies on NBS
Lack of public awareness and low level of education among mothers30,31
Low accessibility to screening facilities31
Limited diagnostic laboratory materials supply and stock-outs31,32  
Enrollment and follow-up  
○ Existing well-resourced SCD clinics. Education of families using standardized text on the importance of follow-up30,31
○ Government ownership
○ Funding from industry partnerships and technical support
○ Collection of proper and adequate contact information for use in tracing patients should they not return to health facility35,37
○ Integration of NBS into maternal and child health programs in primary health care due to the cost of transport. Follow-up care should be designed for well babies instead of taking them into very busy pediatric clinics in tertiary health care centers. 
Denial of positive test results by parents because of apparently healthy babies within the first 6 months and stigma30,34
Low availability of, accessibility to, and affordability of comprehensive care services31
Unsuccessful tracking due to dynamics of mobile phone numbers (wrong or disconnected numbers)35
Delay in communicating test result and relocation of family after36  

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