The constraints for provision of appropriate preeclampsia screening service in health institutions in Mekelle City, Tigray, Ethiopia, 2019/20 G.C.
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Date
2020-11
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Addis Abeba University
Abstract
Background: Pre-eclampsia/eclampsia is one of the leading causes of maternal and perinatal
morbidity and mortality worldwide affecting 2–8% of pregnancies. In Ethiopia severe preeclampsia/
eclampsia accounts for 11% of maternal deaths among the five major causes.
Optimizing health care to prevent and treat women with hypertensive disorders is a necessary
step towards reducing maternal and infant mortality and morbidity. Many developing countries
including Ethiopia face difficulties in using world health organization recommended practices
for preeclampsia screening. Therefore, the aim of this study is to assess the factors or constraints
associated with preeclampsia screening.
Objective: To assess the status of appropriate preeclampsia screening service during antenatal
care follow-ups and the constraints for the provision of this service in health institutions in
Mekelle, Tigray, Ethiopia from April to September 2020 G.C.
Method: Institution based quantitative cross sectional study design with internal comparison was
applied in Mekelle city, Ethiopia from April to September 2020 G.C. A total of 268 samples;
Doctors, health officers, midwives and nurses in antenatal care unit of the governmental and
private health institutions in Mekelle were interviewed. The data collection was done through
observation, reviewing of clients‟ charts and interviewer administered questionnaires by trained
data collectors. Quota sampling method was used to select the health workers in the antenatal
care stream. Multiple logistic regression was applied to identify the factors and adjusted odds
ratio (AOR) with corresponding 95% confidence interval was used to show the strength of
association and a P value of <0.05 was used to declare statistical significance.
Result: The magnitude of appropriate preeclampsia screening service among the health
professionals was 140 (52.2% with 95% CI: 46.1-58.4). The factors significantly associated with
appropriate preeclampsia screening were; profession type for one category i.e. nurses
(AOR=0.045, 95% CI: 0.01-0.197), level of knowledge (AOR =4.17, 95% CI: 1.903-9.142),
resources i.e. health workers in the ANC unit, BP cuffs, urine containers, dipsticks and
laboratory (AOR =2.55, 95% CI: 1.091-5.965) and guideline 22.14 (AOR=22.14, 95% CI:
6.539-74.947).
Conclusion: Around half i.e. 47.8% of the health professionals were not providing appropriate
preeclampsia screening service due to different reasons from lack of knowledge to lack of
resources and guideline issues which indicates that work still needs to be done on these areas in
order to improve appropriate preeclampsia screening service.
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Keywords
Pre-eclampsia,eclampsia