Barriers and enablers of early health-seeking behaviour among women with preeclampsia and eclampsia at a National Referral Hospital

Abstract

Background Globally, about 2-8% of women experience hypertensive disorders in pregnancy (HDPs), including preeclampsia and eclampsia. These disorders are thus, the second leading cause of maternal mortality and morbidity across the globe and predispose women to an increased risk of cardiovascular, cerebrovascular, and renal disease later in life. Despite preeclampsia/eclampsia (PE/E) being one of the most serious forms of HDPs, accounting for 6% of maternal deaths among pregnant women in Uganda, there is still limited research describing barriers and enablers of early health-seeking behaviour amongst women with PE/E, yet some women with PE/E still come in as emergencies in critical conditions. Broad objective To explore the barriers and enablers of early health-seeking behaviour amongst women with PE/E at Kawempe National Referral Hospital. Methods This was an explorative qualitative design, ensuring an in-depth understanding of the phenomenon. A total of 18 participants with a previous diagnosis of PE/E either during the antenatal or postnatal period were involved and sampled using maximum variation sampling. Data was collected through an in-depth interview using a semi-structured interview guide from July to August 2023 and analyzed manually using inductive content analysis. Results The modifiable barriers to health-seeking behaviour included limited awareness and knowledge about PE/E, sociocultural barriers, financial constraints, psychological influences, and structural and logistical aspects of the health facility, including fixed schedules and drug stockouts. This study indicated that women were well supported socially, had increased autonomy and decision-making power in healthcare seeking, perceived well the healthcare services, and feared negative outcomes, which were enablers of seeking healthcare early. Conclusion The barriers to early health seeking among women with PE/E were individual, healthcare system and community barriers, while the enablers were related to the social, individual and healthcare system. There is a critical need for community education and sensitization to create awareness and increase women’s knowledge about HDPs. Families, friends and partners of women with PE/E are implored to continue offering the necessary psycho-social support.