Table 2.

Overcoming barriers to pregnancy-based screening for congenital Chagas disease

Barrier	Approach to overcoming barrier
Maternal
At risk mothers’ lack of awareness of morbidity of Chagas disease	Increase knowledge; empower women to request testing
Healthcare provider
Lack of knowledge of Chagas disease	Educational programs; medical record prompts
Time to educate patients	Restructure appointments; add personnel for patient education
Lack of familiarity with ordering screening test	Educational sessions; medical record prompts
Lack of familiarity with obtaining confirmatory test	Educational sessions; medical record prompts
Decision-making for confirmed positive test	Consultation with a Chagas disease expert
Other considerations
Cost of testing	Bundled into charges for pregnancy-based serologic testing
Adherence to referral of mother after delivery and family member evaluation	Care coordination
Adherence to assessment and treatment of newborns at risk	Care coordination