Knowledge and skills on managing eclampsia among nurse-midwives working at Mnazi mmoja hospital, Unguja Zanzibar.

Abstract

Background: Eclampsia accounts for over 50,000 maternal deaths a year worldwide and it is associated with very high fatality rate. It is for this reason knowledge of managing eclampsia among health workers is essential in reducing maternal morbidity and mortality. Nurse–midwives can play a major role in prevention of maternal death related to eclampsia. It is therefore important to assess Nurse-midwives knowledge in managing eclampsia.

Aim of the study: The aim of the study was to assess the knowledge and Skills regarding management of Eclampsia among nurses and midwives working at Mnazi Mmoja Hospital, Zanzibar.

Materials and Methods: A quantitative research methodology using descriptive cross section and observation study was used. Nurses-midwives knowledge and skills in management of eclampsia were tested by using self-administered questionnaires and observation checklist adopted from Jhpiego, 2011. The study recruited 129 Nurse-midwives who work at Mnazi Mmoja Hospital, Zanzibar. Data collection period was two weeks, commencing from 15th June to 30th June, 2013. Data was collected from the field through data coded and entered into SPSS version 20 for descriptive and inferential statistics.

Result: All result presented in percentages in this study were rounded off. The findings of this study revealed that, less than half of study participants (43%) had good knowledge and about 60% had poor skills in managing eclampsia. Few participants (27%) had knowledge on guidelines used in managing eclampsia. The statistical evidence shows that there is relationship between knowledge and total year of experiences (p= 0.040 < 0.05) but no significant difference was found between knowledge level of staff nurse-midwives and selected variables like age (p= 0.3 > 0.05) and professional qualifications (p=0.51> 0.05). Drugs shortage (58%) and equipment shortage (50%) were among barriers faced by Nurse-midwives in managing eclampsia. Enough drugs and supplies (58%) and training/seminars (40%) were suggested as the way of enhancing management of women with eclampsia.

Conclusion A study revealed that nurse-midwives had knowledge and practice gaps in areas of managing eclampsia. Provider’s practices were not at appropriate level or in line with guidelines. Few Nurse-midwives reported to have attended in-service training on managing eclampsia. Resuscitation equipment and essential drugs for managing eclampsia are not enough and not regularily available.

Recommendation The Hospital administration should ensure there is regular availability of essential drugs and other supplies used in managing eclampsia. Hospital management should formulate operational team of assessment and should ensure the adherence to the use of checklist and guidelines in managing women with eclampsia. On job training, seminars, continuing education and mentorship programmes were recommended for enhancing the knowledge of nurse-midwives in managing eclampsia.

Key words: Eclampsia, Knowledge, skills, Nurse-midwives, Zanzibar.