Abstract
Eclampsia-related conditions are the second leading direct cause of obstetric deaths in Bangladesh. Efforts to prevent such deaths in low- and middle-income countries are increasingly focused on task shifting at the primary care level to enable frontline providers to screen and initiate treatment for women with preeclampsia, severe preeclampsia, and eclampsia (PE/SPE/E). The MaMoni Health Systems Strengthening project (funded by the United States Agency for International Development) implemented a magnesium sulfate intervention at primary care facilities in 4 Bangladesh districts in 2016 and 2017. The project trained frontline providers through a cascade approach from the national to the union level. A PE/SPE/E patient algorithm, digital blood pressure machines, and eclampsia kits with magnesium sulfate were supplied to service providers at each facility. We conducted a retrospective record review of facility-level data to assess the degree to which newly trained frontline providers adhered to a protocol that incorporated the use of magnesium sulfate for SPE/E in primary care settings. In total, 283 women were found to have PE/SPE/E. Fifty-four percent were managed according to the protocol. The required supplies were present at each facility, but some issues existed with regard to availability and functionality of blood pressure apparatuses. Challenges related to recordkeeping and service quality limited the analysis. Frontline providers need refresher trainings, ongoing supervision, properly calibrated blood pressure devices, and performance monitoring support in order to improve screening and management of PE/SPE/E in primary care facilities.
Highlights
Eclampsia-related conditions are the second leading direct cause of obstetric deaths in Bangladesh
A routine service delivery point survey conducted quarterly by the project was used to check whether magnesium sulfate. PE/SPE/E (MgSO4) and blood pressure (BP) apparatuses were present at each union health and family welfare centers (UH&FWCs)
None of the women with documented eclampsia were treated with MgSO4
Summary
Eclampsia-related conditions are the second leading direct cause of obstetric deaths in Bangladesh Efforts to prevent such deaths in low- and middle-income countries are increasingly focused on task shifting at the primary care level to enable frontline providers to screen and initiate treatment for women with preeclampsia, severe preeclampsia, and eclampsia (PE/SPE/E). Global Health: Science and Practice 2019 | Volume 7 | Number 3 of frontline providers, and systems challenges that lead to delays in women receiving necessary treatment.[2,3,4] In Bangladesh, eclampsia-related conditions are the second leading direct cause of obstetric deaths and lead to 24% of all maternal deaths.[5] Over 1,000 women die each year in Bangladesh due to PE/SPE/E. They either do not access the health system at all, are not screened properly, or do not receive timely treatment due to delays in (1) making the decision to seek care, (2) being transported to receive care, and (3) receiving the required treatment at the care site where it is available.[6,7]
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.