Implementation of preconceptional carrier screening for cystic fibrosis and haemoglobinopathies: a sociotechnical analysis

Achterbergh, Roos and Lakeman, Phillis and Stemerding, Dirk and Moors, Ellen H.M. and Cornel, Martina C. (2007) Implementation of preconceptional carrier screening for cystic fibrosis and haemoglobinopathies: a sociotechnical analysis. Health Policy, 83 (2-3). pp. 277-286. ISSN 0168-8510

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Abstract:	Objective: To obtain more insight into the process of potential implementation of a screening program, which aims to identify carriers of cystic fibrosis and haemoglobinopathies before pregnancy, in order to enable couples at high risk of having a child with these disorders, to make informed reproductive decisions. - Methods: Use of sociotechnical analysis, based on a model of co-evolution between technology and society, and, for comparison, the study of the implementation processes of two already existing health care programs with similar aspects to the screening program at issue. - Results: Factors important for success appeared to be the existence of sociotechnical niches, in which technological options can be developed and studied in an experimental setting; a structural approach of providing information to future parents; a party that can articulate demand; governmental involvement in the attunement between various stakeholders; and a screening infrastructure in which large-scale DNA diagnostic services are available. - Conclusions: Successful implementation of preconceptional carrier screening for cystic fibrosis and haemoglobinopathies will depend on changes at both regime and landscape level, including the establishment of a new preconceptional health care setting and a clearly visible public health authority which can coordinate, monitor and evaluate such an initiative in public health care.
Item Type:	Article
Copyright:	© 2007 Elsevier
Faculty:	Management and Governance (SMG)
Research Group:	Science, Technology and Policy Studies (STePS)
Link to this item:	http://purl.utwente.nl/publications/78619
Official URL:	http://dx.doi.org/10.1016/j.healthpol.2007.02.007
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