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Reproductive Health
Published in: Reproductive Health 1/2016

Open Access 01-06-2016 | Research

The feasibility of community level interventions for pre-eclampsia in South Asia and Sub-Saharan Africa: a mixed-methods design

Authors: Asif Raza Khowaja, Rahat Najam Qureshi, Diane Sawchuck, Olufemi T. Oladapo, Olalekan O. Adetoro, Elizabeth A. Orenuga, Mrutyunjaya Bellad, Ashalata Mallapur, Umesh Charantimath, Esperança Sevene, Khátia Munguambe, Helena Edith Boene, Marianne Vidler, Zulfiqar A. Bhutta, Peter von Dadelszen, CLIP Working Group

Published in: Reproductive Health | Special Issue 1/2016

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Abstract

Background

Globally, pre-eclampsia and eclampsia are major contributors to maternal and perinatal mortality; of which the vast majority of deaths occur in less developed countries. In addition, a disproportionate number of morbidities and mortalities occur due to delayed access to health services. The Community Level Interventions for Pre-eclampsia (CLIP) Trial aims to task-shift to community health workers the identification and emergency management of pre-eclampsia and eclampsia to improve access and timely care. Literature revealed paucity of published feasibility assessments prior to initiating large-scale community-based interventions. Arguably, well-conducted feasibility studies can provide valuable information about the potential success of clinical trials prior to implementation. Failure to fully understand the study context risks the effective implementation of the intervention and limits the likelihood of post-trial scale-up. Therefore, it was imperative to conduct community-level feasibility assessments for a trial of this magnitude.

Methods

A mixed methods design guided by normalization process theory was used for this study in Nigeria, Mozambique, Pakistan, and India to explore enabling and impeding factors for the CLIP Trial implementation. Qualitative data were collected through participant observation, document review, focus group discussion and in-depth interviews with diverse groups of community members, key informants at community level, healthcare providers, and policy makers. Quantitative data were collected through health facility assessments, self-administered community health worker surveys, and household demographic and health surveillance.

Results

Refer to CLIP Trial feasibility publications in the current and/or forthcoming supplement.

Conclusions

Feasibility assessments for community level interventions, particularly those involving task-shifting across diverse regions, require an appropriate theoretical framework and careful selection of research methods. The use of qualitative and quantitative methods increased the data richness to better understand the community contexts.

Trial registration

Appendix
Available only for authorised users
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Metadata
Title
The feasibility of community level interventions for pre-eclampsia in South Asia and Sub-Saharan Africa: a mixed-methods design
Authors
Asif Raza Khowaja
Rahat Najam Qureshi
Diane Sawchuck
Olufemi T. Oladapo
Olalekan O. Adetoro
Elizabeth A. Orenuga
Mrutyunjaya Bellad
Ashalata Mallapur
Umesh Charantimath
Esperança Sevene
Khátia Munguambe
Helena Edith Boene
Marianne Vidler
Zulfiqar A. Bhutta
Peter von Dadelszen
CLIP Working Group
Publication date
01-06-2016
Publisher
BioMed Central
Published in
Reproductive Health / Issue Special Issue 1/2016
Electronic ISSN: 1742-4755
DOI
https://doi.org/10.1186/s12978-016-0133-0

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