Management of preeclampsia/eclampsia in Dar es Salaam public health facilities: availability of supplies and knowledge of healthcare workers

Abstract

Background: Pre-eclampsia and eclampsia are the hypertensive disorders of pregnancy that affect 5-10% of all pregnancies. Eclampsia is associated with very high case fatality rate and a major contributor to maternal deaths. Early screening using simple tools and proper treatment of pre-eclampsia and eclampsia are important in reducing the maternal and neonatal morbidity and mortality. Objective: To assess the availability of supplies and knowledge of healthcare workers in managing patients with preeclampsia/eclampsia in Dar-es-salaam public health facilities. Methodology: This was a descriptive cross-sectional study involving 30 public health facilities in Dar es Salaam that offer reproductive and child services. Checklist was used to assess availability of instruments and drugs in the health facilities and, a structured questionnaire was used to assess knowledge of the healthcare workers. To assess knowledge of the healthcare workers, a score in the questionnaire of 8 - 17 marks was for adequate knowledge and a score less than 8 were for inadequate knowledge. Results: All the public health facilities had working blood pressure machines and stethoscopes for blood pressure screening, less than half had dipsticks for detection of protein in urine. Availability of drugs for treating preeclampsia and eclampsia in the health facilities was low, less than half of had magnesium sulphate for controlling and prevention of seizures. Availability of antihypertensives was generally low only 40% of health facilities had methyldopa, 37%most mentioned risk factor. Overall more than half of the healthcare workers had adequate knowledge in screening for risk factors, symptoms of severe preeclampsia and offer appropriate treatment. Conclusion: The study has revealed that public health facilities lack essential supplies for screening and managing patients with preeclampsia and eclampsia. Availability of essential drugs for patients with preeclampsia/eclampsia is low in health facilities especially in the lower level of care. Majority of the healthcare workers have adequate knowledge to manage patients with preeclampsia and eclampsia.