Discrepancies between clinicians and rural healthcare workers regarding referral procedures based on blood pressure measurements

Abstract

Hypertensive disorders of pregnancy are the third most common cause of maternal mortality worldwide, and the proportion of deaths resulting from these disorders is increasing [1,2]. Proper management begins with correct diagnosis and appropriate referral decisions. Within maternity referral networks in low-resource countries, rural healthcare workers are the first to identify hypertension, which requires accurate equipment and proper measurement technique. The aim of the present study was to assess whether referral procedures based on blood pressuremeasurementswere consistent throughout a maternity referral network. Seventy-five semi-structured interviews were performed at healthcare centers—teaching hospital (n = 1), district hospitals (n = 10), health clinics (n = 11), and community health posts (n = 8)—within a convenience sample of 9 districts in Ghana. Participants were asked to define the blood pressure measurement that would be considered high and warrant treatment and/or referral. Participant groups included obstetricians and physicians, midwives/nurses, and community health workers (CHWs). The