Preeclampsia prevention: a survey study on knowledge and practice among prenatal care providers in Ethiopia

Abstract

BackgroundKnowledge and practice gap among providers has been cited among factors behind underutilization of aspirin for preeclampsia prevention, globally. ObjectiveTo determine the knowledge and practice level of prenatal care providers at a national tertiary referral hospital in Ethiopia and it's catchment health institutions. Study DesignThis was a cross-sectional survey on the knowledge and practice of preeclampsia prevention through ASA prophylaxis among prenatal care providers at St. Paul's Hospital Millennium Medical College (Ethiopia) and it's catchment health institutions. Data were collected prospectively using a structured questionnaire on ODK. The primary objective of our study was determining the knowledge and practice level among the prenatal care providers. Data were analyzed using SPSS version 23. Simple descriptive analysis were employed to analyze the data. Proportions and percentages were used to present the results. ResultsA total of 92 prenatal care providers working at 17 health institutions were approached and 78 of them agreed to participate in the study, constituting a response rate of 84.8%. The mean score of knowledge and practice of prevention for pre-eclampsia using Aspirin was 42.9(±0.13) and 45.8(±0.07) respectively. Most of the providers had poor knowledge (score less than 50%) and poor practice (score less than 50). Only 23.8% (19/78) and 36.3% (29/78) had good knowledge and good practice, respectively. More than half (61.3%, 49/78) of the respondents mentioned “lack of national guidelines for use of aspirin in pregnancy” as the main factor that impacted their practice on Aspirin for preeclampsia prevention in pregnant women. Among the resources utilized as a reference for practice of use of aspirin for pre-eclampsia prevention, FIGO or WHO guidelines (56.3%, 45/78), followed by ACOG (45%, 36/78) and clinical judgment (45%, 36/78) were the most frequently used resources. ConclusionResults of this study support previous reports of significant knowledge-to-practice gap in the use of ASA prophylaxis for prevention of preeclampsia, among prenatal care providers. It underscores the need for immediate action in narrowing this gap among the providers through availing practical national guidelines for prevention of pre-eclampsia and in-service trainings.