<![CDATA[Background: Syphilis screening during pregnancy is a critical strategy to prevent adverse outcomes for mothers and newborns. However, in rural areas, the success of screening programs is often influenced by structural barriers and poorly addressed social support systems. Objective: This study aimed to analyze the determinants of successful syphilis screening among pregnant women in Pakong District, Pamekasan, with an emphasis on service accessibility and community support. Methods: This study employed a sequential explanatory mixed methods design. The study population was all pregnant women in the Pakong Community Health Center (Puskesmas) working area from January to December 2024, with a sample of 1,552 respondents drawn using total population sampling. The quantitative phase used a cross-sectional approach analyzed using binary (bivariate and multivariate) logistic regression. The qualitative phase involved in-depth interviews with pregnant women, midwives, and laboratory staff. Thematic analysis was conducted to explain the quantitative findings. Results: Qualitative results indicated that service accessibility and community support were the main determinants of successful screening. Qualitative findings revealed that service accessibility and community support were determinants of successful syphilis screening in rural settings. Conclusion: Strengthening physical access, ensuring the continuity of laboratory services, empowering community cadres, increasing family involvement, and reducing stigma are crucial to increasing the effectiveness and sustainability of syphilis screening programs.]]>
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