Expanding hepatitis B screening in Africa’s antenatal clinics requires more than purchasing diagnostic kits. Health systems must also fund staff training, reliable supplies, follow-up care and timely vaccination for newborns. Without that wider investment, identifying an infection may not translate into preventing the next one.
For healthcare managers and procurement teams, the challenge is to build a complete service around an existing pregnancy-care visit—and measure whether patients receive the care that follows.
The scale of the need is substantial. The World Health Organization estimates that 240 million people were living with chronic hepatitis B in 2024. Its African Region accounted for 68% of new chronic infections that year. These are regional disease-burden estimates, rather than measures of antenatal screening coverage. [1]
What the screening figures actually show
A March 2026 market memo from the Clinton Health Access Initiative, updated in May, reports average 2024 antenatal screening coverage of 44% for hepatitis B, compared with 93% for HIV and 86% for syphilis.
Those figures require careful interpretation. The assessment covered 16 selected country programmes across Africa and Asia. Hepatitis B coverage data were available from eight countries, while HIV and syphilis data came from 15. The percentages therefore describe different reporting groups, not a representative comparison across Africa. [2]
Nevertheless, the findings identify an implementation problem: adding screening to national policy does not automatically deliver testing at the clinic.
In written responses to AfricaBusiness.com, Abbott’s medical team identified fragmented implementation, limited test procurement and insufficient dedicated funding as recurring barriers. These observations reflect the company’s regional experience rather than a continent-wide survey.
Integration does not require a single device
Integrated screening means coordinating services for HIV, syphilis and hepatitis B within antenatal care. It can involve separate rapid tests or a combined HIV/syphilis test alongside a hepatitis B surface antigen test.
A triple-combination product is another possible format. CHAI distinguishes the broader service model from the emerging market for these products. Procurement decisions should therefore consider the available testing pathway, national requirements and supply reliability—not assume that integration depends on buying one particular device. [2]
For clinic managers, the practical questions include who performs testing, how results are recorded, who explains them and how a positive result triggers further assessment.
The budget must cover the whole pathway
Asked about the cost of adding hepatitis B screening, Abbott did not provide a standard figure. Its team said costs vary by country, procurement arrangements, testing volume and implementation model.
That limitation matters. A test-kit price alone cannot establish the cost of delivering a functioning screening programme.
Budget planning should include staff time, training, quality assurance, stock management, additional assessment and referral. It should also account for medicines and vaccination services where required.
An intervention can offer good value for its health benefits while still requiring additional near-term spending. Decision-makers should distinguish that question from whether it immediately reduces expenditure.
A positive test must lead to care
WHO recommends hepatitis B testing for pregnant women so that preventive measures can be considered. A positive screening result should lead to assessment under the applicable clinical pathway, including evaluation of the mother’s own treatment needs and eligibility for antiviral prophylaxis to reduce transmission. [3,4]
Screening also does not replace infant vaccination. WHO recommends a hepatitis B vaccine dose for all babies as soon as possible after birth, within 24 hours, followed by completion of the vaccination series. The universal birth-dose recommendation is not conditional on a positive maternal test. [3]
Abbott’s responses highlight operational barriers including home deliveries, births outside normal clinic hours, supply-chain constraints and doses being delayed until discharge. Addressing these problems requires coordination between antenatal services, maternity facilities and immunisation teams.
Measure completed care, not just tests purchased
For funders and healthcare operators, useful performance measures extend beyond procurement volumes. They include screening coverage, stock-outs, completion of follow-up assessment, access to indicated prophylaxis and timely infant vaccination.
These measures help identify where the pathway breaks down. A clinic may increase testing while patients remain unable to obtain further assessment, or a maternity service may hold vaccine stock without consistently delivering the birth dose on time.
The investment priority is therefore a connected service: diagnosis linked to clinical action, with funding and accountability at each stage.
This article draws on published WHO and CHAI sources and written responses supplied by Abbott’s medical team. Abbott is a supplier of diagnostic products.
Sources and information
[1] WHO — Global hepatitis report 2026
[2] CHAI — Integrated Screening in Antenatal Care, March 2026, updated May 2026