Healthcare Workers’ Self-Reported Competence in the Management of Pre-Eclampsia and Eclampsia at Primary Health Care Facilities in Ekiti State, Nigeria

Abstract

Background: Eclampsia remains an enigmatic obstetrics catastrophe that ranks second to obstetric hemorrhage as the leading cause of maternal mortality in sub-Saharan Africa. Early detection of pre-eclampsia and emergency management of severe pre-eclampsia and eclampsia are important in reducing morbidity and mortality from this life-threatening disease spectrum. This study aimed to assess the factors associated with competencies in the detection and emergency management of Pre-eclampsia and Eclampsia by Primary Healthcare workers in Ekiti State, South West Nigeria. Methods: This study was a cross-sectional self-administered questionnaire-based survey. Healthcare personnel working at four primary healthcare facilities completed self-administered questionnaires at a training session on Basic and Emergency Obstetric and Neonatal care (BemONC). Results: The questionnaires were completed by 302 healthcare workers, the majority of whom were Community Extension Health Workers in Ekiti State. Among the participants, 68.2%, 2%, and 1% reported accurate detection, accurate emergency management, and accurate detection with the emergency management of Pre-eclampsia and Eclampsia respectively. The odds of self-reported accurate detection of Pre-eclampsia and Eclampsia is increased by 7 in those with more than 25 years of experience. Community Extension Care Workers were about 78% less likely to be able to detect Pre-eclampsia and Eclampsia compared with doctors. Conclusion: Although the majority of the healthcare personnel at the primary healthcare level could detect Pre-eclampsia and Eclampsia, only a few reported the ability to institute accurate emergency management and referral protocol. Training and retraining of primary health care workers on essential and emergency obstetrics care are advocated. Key words: Healthcare workers; Primary Health care; Competence; Pre-eclampsia; Eclampsia.