Assessment of the management of nausea and vomiting of pregnancy (NVP) by primary care providers in Nigerian primary care settings: A descriptive study

Abstract

Nigeria has one of the highest maternal morbidity and mortality rates in the world. A strategic approach to reverse this trend is timely recognition and prompt treatment of pregnancy related diseases at primary care levels. This study assessed the knowledge, attitude and treatment practices of primary care providers (PCPs) on Nausea and Vomiting of Pregnancy (NVP) at primary care settings in Osun State, south-west Nigeria. The study employed a descriptive cross-sectional design and two-stage sampling technique. Assessment of the study outcomes (level of knowledge, attitude and practice) was done using a validated questionnaire and were categorized based on performance scores. Data was collected using a pre-tested questionnaire to elicit information on socio-demographic characteristics, level of knowledge of NVP, attitudes on roles and specific tasks in caring for NVP and practices in the management of NVP. The data collected was analyzed using descriptive and inferential statistics . Bivariate analysis comprised Chi-square test on association between level of knowledge of NVP and job cadres while correlation test assessed strength of relationship between level of knowledge of NVP and years of experience. Analytical statistics considered a p < 0.05 to be statistically significant. Of the 250 PCPs enrolled into the study, only 1.2% demonstrated good knowledge of NVP and its recommended management modalities. There was a statistically significant association between the level of knowledge of PCPs and job cadres (χ 2 = 2.840, p = 0.039) while correlation showed a statistically positive relationship between level of knowledge and years of experience (r = 0.272, p = 0.001). Less than half [22 (8.8%)], [47 (18.8%)] and [3 (1.2%)] of the nurses, community workers and doctors respectively agreed NVP is a purely natural phenomenon and requires no treatment, while more than half [36 (14.4%)] of the health assistants agreed that NVP is natural and requires no treatment. Almost all the respondents had recommended pharmacological measures for the treatment of NVP during their professional practice and encountered complications with their use. The level of knowledge of NVP and its management was very low among the PCPs. An educational tool aimed at bridging the knowledge gap may lead to improved care.