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Reproductive Health
Published in: Reproductive Health 2/2016

Open Access 01-09-2016 | Research

Community health worker knowledge and management of pre-eclampsia in southern Mozambique

Authors: Helena Boene, Marianne Vidler, Orvalho Augusto, Mohsin Sidat, Eusébio Macete, Clara Menéndez, Diane Sawchuck, Rahat Qureshi, Peter von Dadelszen, Khátia Munguambe, Esperança Sevene, the CLIP Feasibility Working Group

Published in: Reproductive Health | Special Issue 2/2016

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Abstract

Background

Mozambique has drastically improved an array of health indicators in recent years, including maternal mortality rates which decreased 63 % from 1990–2013 but the rates still high. Pre-eclampsia and eclampsia constitute the third major cause of maternal death in the country. Women in rural areas, with limited access to health facilities are at greatest risk. This study aimed to assess the current state of knowledge and the regular practices regarding pre-eclampsia and eclampsia by community health workers in southern Mozambique.

Methods

This mixed methods study was conducted from 2013 to 2014, in Maputo and Gaza Provinces, southern Mozambique. Self-administered questionnaires, in-depth interviews and focus group discussions were conducted with CHWs, district medical officers, community health workers’ supervisors, Gynaecologists-Obstetricians and matrons. Quantitative data were entered into a database written in REDCap and subsequently analyzed using Stata 13. Qualitative data was imported into NVivo10 for thematic analysis.

Results

Ninety-three percent of CHW had some awareness of pregnancy complications. Forty-one percent were able to describe the signs and symptoms of hypertension. In cases of eclampsia, CHWs reported to immediately refer the women. The vast majority of the CHWs surveyed reported that they could neither measure blood pressure nor proteinuria (90 %). Fewer reported confidence in providing oral antihypertensives (14 %) or injections in pregnancy (5 %). The other community health care providers are matrons. They do not formally offer health services, but assists pregnant women in case of an emergency. Regarding pre-eclampsia and eclampsia, matrons were unable to recognise these biomedical terms.

Conclusions

Although CHWs are aware of pregnancy complications, they hold limited knowledge specific to pre-eclampsia and eclampsia. There is a need to promote studies to evaluate the impact of enhancing their training to include additional content related to the identification and management of pre-eclampsia and eclampsia.
Appendix
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Metadata
Title
Community health worker knowledge and management of pre-eclampsia in southern Mozambique
Authors
Helena Boene
Marianne Vidler
Orvalho Augusto
Mohsin Sidat
Eusébio Macete
Clara Menéndez
Diane Sawchuck
Rahat Qureshi
Peter von Dadelszen
Khátia Munguambe
Esperança Sevene
the CLIP Feasibility Working Group
Publication date
01-09-2016
Publisher
BioMed Central
Published in
Reproductive Health / Issue Special Issue 2/2016
Electronic ISSN: 1742-4755
DOI
https://doi.org/10.1186/s12978-016-0220-2

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