Screening and Referral for High Risk Pregnancies Among Primary Health Care Workers in Rural Communities in Abia State, Nigeria

Abstract

Abstract Introduction Screening for conditions like hypertension, diabetes mellitus and anaemia during antenatal reduces the chances of complications in pregnancy. Health systems in Nigeria are structured such that cases that cannot be managed in a lower health facility are referred to higher hospitals with more expertise and equipment. This study was conducted to determine the screening and referral patterns of high risk pregnancies among health workers in rural communities in Abia state, Nigeria. Materials and Methods This was a descriptive cross-sectional study conducted among 400 staff of Primary Health Care Centres in the three senatorial zones of Abia state, Nigeria from January to June, 2021. Primary health centres were grouped using cluster sampling while selection of the respondents was by simple random sampling by balloting. Quantitative and qualitative methods were used to collect data. Data analysis was done using SPSS version 21.0 and results presented in tables. Results Two hundred and sixty-seven (67.3%) respondents knew that gestational diabetes mellitus was associated with pregnancy while 385 (96.3%) screened for gestational diabetes mellitus on first day of antenatal care visit. Three hundred and forty-three (85.7%) respondents screened for hypertension in pregnancy during antenatal. All respondents, 400 (100.0%) knew that anaemia could lead to abortions. Three hundred and thirty-three (83.3%) respondents referred difficult cases to higher facilities, while 49 (12.2%) invite doctors to their facilities. Challenges with referrals include lack of facility ambulances, lack of access roads and lack of funds. Conclusion Health facilities are not equally equipped to handle high risk pregnancies. Also, health workers are not competent to manage high risk pregnancies. Referral strategies and protocols are lacking in the health facilities studied.