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Community health worker knowledge and management of pre-eclampsia in southern Mozambique.

Boene, H; Vidler, M; Augusto, O; Sidat, M; Macete, E; Menéndez, C; Sawchuck, D; Qureshi, R; von Dadelszen, P; Munguambe, K; et al. Boene, H; Vidler, M; Augusto, O; Sidat, M; Macete, E; Menéndez, C; Sawchuck, D; Qureshi, R; von Dadelszen, P; Munguambe, K; Sevene, E; CLIP Feasibility Working Group (2016) Community health worker knowledge and management of pre-eclampsia in southern Mozambique. Reproductive Health, 13 (Suppl 2). p. 105. ISSN 1742-4755 https://doi.org/10.1186/s12978-016-0220-2
SGUL Authors: von Dadelszen, Peter

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Abstract

BACKGROUND: Mozambique has drastically improved an array of health indicators in recent years, including maternal mortality rates which decreased 63 % from 1990-2013 but the rates still high. Pre-eclampsia and eclampsia constitute the third major cause of maternal death in the country. Women in rural areas, with limited access to health facilities are at greatest risk. This study aimed to assess the current state of knowledge and the regular practices regarding pre-eclampsia and eclampsia by community health workers in southern Mozambique. METHODS: This mixed methods study was conducted from 2013 to 2014, in Maputo and Gaza Provinces, southern Mozambique. Self-administered questionnaires, in-depth interviews and focus group discussions were conducted with CHWs, district medical officers, community health workers' supervisors, Gynaecologists-Obstetricians and matrons. Quantitative data were entered into a database written in REDCap and subsequently analyzed using Stata 13. Qualitative data was imported into NVivo10 for thematic analysis. RESULTS: Ninety-three percent of CHW had some awareness of pregnancy complications. Forty-one percent were able to describe the signs and symptoms of hypertension. In cases of eclampsia, CHWs reported to immediately refer the women. The vast majority of the CHWs surveyed reported that they could neither measure blood pressure nor proteinuria (90 %). Fewer reported confidence in providing oral antihypertensives (14 %) or injections in pregnancy (5 %). The other community health care providers are matrons. They do not formally offer health services, but assists pregnant women in case of an emergency. Regarding pre-eclampsia and eclampsia, matrons were unable to recognise these biomedical terms. CONCLUSIONS: Although CHWs are aware of pregnancy complications, they hold limited knowledge specific to pre-eclampsia and eclampsia. There is a need to promote studies to evaluate the impact of enhancing their training to include additional content related to the identification and management of pre-eclampsia and eclampsia.

Item Type: Article
Additional Information: © 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Keywords: Community health workers, Eclampsia management, Knowledge, Mozambique, Pre-eclampsia, Obstetrics & Reproductive Medicine, 1114 Paediatrics And Reproductive Medicine
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Reproductive Health
ISSN: 1742-4755
Language: ENG
Dates:
DateEvent
30 September 2016Published
9 August 2016Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
UNSPECIFIEDBill and Melinda Gates Foundationhttp://dx.doi.org/10.13039/100000865
PubMed ID: 27719683
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/108314
Publisher's version: https://doi.org/10.1186/s12978-016-0220-2

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