Abstract
BACKGROUND: Despite the availability of cost-effective treatments, maternal syphilis continues to contribute significantly to preventable stillbirths and congenital syphilis cases worldwide. This scoping review aimed to identify and characterize maternal health interventions designed to prevent mother-to-child transmission (PMTCT) of syphilis globally, using a modified Intervention Mapping (IM) framework. METHODS: We conducted a scoping review of maternal health interventions targeting PMTCT of syphilis published between January 2010 and August 2023. Searches were performed in PubMed, Medline Ovid, and Embase, supplemented by manual reference screening. Eligible studies described at least one maternal health intervention addressing syphilis PMTCT and were analyzed using a five-step modified IM framework. Data extraction focused on intervention characteristics, settings, theoretical foundations, behavioral and environmental outcomes, and delivery strategies. Summary statistics and a narrative synthesis were used to analyze findings. RESULTS: A total of 32 articles representing 30 unique interventions met the inclusion criteria. Most interventions were conducted in North and South America and targeted pregnant women and healthcare providers. Over 70% of interventions were multi-level, addressing both individual and environmental factors. Behavioral outcomes primarily focused on syphilis screening, treatment, and early prenatal care, while environmental outcomes emphasized provider practices and partner involvement. However, few interventions included community engagement or targeted high-risk subgroups such as sex workers or adolescents. Commonly used approaches included health education, provider training, partner notification, and quality improvement. Only a minority of studies reported the use of theoretical frameworks, and less than one-third included formal evaluation data. CONCLUSIONS: This review highlights both the promise and gaps in existing maternal health interventions for syphilis PMTCT. Interventions frequently addressed individual and provider behaviors but lacked integration of community-level strategies and theoretical guidance. Future interventions should prioritize theory-based designs, rigorous evaluation, and broader inclusion of high-risk populations. The modified IM framework proved useful for systematically mapping intervention components and identifying implementation and evaluation gaps. TRIAL REGISTRATION: Not applicable. This study is a scoping review and does not report results from a clinical trial.