205-POS

Abstract

Objectives To assess the feasibility of a multi-country Community Level Interventions for Pre-eclampsia (CLIP) Trial in the African and South Asian contexts. Methods A mixed methodology approach guided by normalization process theory was used in Nigeria, Mozambique, Pakistan, and India. Multiple methods of data collection were employed to explore enabling and impeding factors for the CLIP package utilization. Qualitative data were collected through participatory observation, document review, focus group discussions and in-depth interviews with diverse groups of community members, key informants at community level, healthcare providers, and policy makers. Quantitative data were collected through health facility assessments and community health workers’ assessments, self-administered questionnaires, and community surveillance. Qualitative thematic analysis was conducted using QSR NVivo v10. Quantitative descriptive analyses was performed on SPSS v19/Epi Info 7. Results Qualitative themes underscored knowledge deficits about pre-eclampsia and poor understanding of progression of illness from pre-eclampsia to eclampsia. Myths and misperceptions widely prevailed surrounding the causes of pre-eclampsia, whereas community practices related to prevention, as well as, case management were deeply rooted in their cultural beliefs, past experiences and perceptions of severity of pre-eclampsia/eclampsia. The quantitative findings from survey highlighted areas for health system capacity building needed to ensure availability of magnesium sulfate at health facilities, equipping community care providers with blood pressure monitoring devices, and training of care providers for diagnosis and management of hypertensive disorders during pregnancy. Conclusions Feasibility assessment for the CLIP Trial was a resource-intensive, but essential, exercise to understand communities prior to the trial. The methodology used in our research work, can be used to inform future trials of this magnitude in high burden countries and elsewhere. Disclosure A.R. Khowaja: None.