Understanding challenges as they impact on hospital-level care for pre-eclampsia in rural Ethiopia: a qualitative study.

Journal: BMJ open

Volume: 13

Issue: 4

Year of Publication: 2023

Affiliated Institutions:  Department of Women and Children's Health, King's College London, London, UK tanya.robbins@kcl.ac.uk. Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK. Department of Women and Children's Health, King's College London, London, UK. Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia. Department of Obstetrics and Gynaecology, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia. Department of Global Health and Social Medicine, King's College London, London, UK.

Abstract summary 

To explore hospital-level care for pre-eclampsia in Ethiopia, considering the perspectives of those affected and healthcare providers, in order to understand barriers and facilitators to early detection, care escalation and appropriate management.A primary and a general hospital in southern Ethiopia.Women with lived experience of pre-eclampsia care in the hospital, families of women deceased due to pre-eclampsia, midwives, doctors, integrated emergency surgical officers and healthcare managers.This study identified numerous systemic barriers to provision of quality, person-centred care for pre-eclampsia in hospitals. Individual staff efforts to respond to maternal emergencies were undermined by a lack of consistency in availability of resources and support. The ways in which policies were applied exacerbated inequities in care. Staff improvised as a means of managing with limited material or human resources and knowledge. Social hierarchies and punitive cultures challenged adequacy of communication with women, documentation of care given and supportive environments for quality improvement.Quality care for pre-eclampsia requires organisational change to create a safe space for learning and improvement, alongside efforts to offer patient-centred care and ensure providers are equipped with knowledge, resources and support to adhere to evidence-based practice.

Authors & Co-authors:  Robbins Tanya T Shennan Andrew A Sandall Jane J Eshetu Guangul Tigist T Demissew Rahel R Abdella Ahmed A Mayston Rosie R Hanlon Charlotte C

Study Outcome 

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Statistics
Citations :  Say L, Chou D, Gemmill A, et al. . Global causes of maternal death: a who systematic analysis. Lancet Glob Health 2014;2:e323–33. 10.1016/S2214-109X(14)70227-X
Authors :  8
Identifiers
Doi : e061500
SSN : 2044-6055
Study Population
Women
Mesh Terms
Pregnancy
Other Terms
change management;health policy;hypertension;obstetrics;organisation of health services;qualitative research
Study Design
Cross Sectional Study
Study Approach
Qualitative,Systemic Review
Country of Study
Ethiopia
Publication Country
England