Barriers and facilitators to adherence to Pre-eclampsia and Eclampsia management guidelines among health workers at Kawempe National Referral Hospital

Abstract

Background: pre-eclampsia /eclampsia is the second leading cause of maternal mortality in Uganda. WHO developed recommendations to guide health workers’ practice when managing patients with PE/E; these guidelines were incorporated into the essential Maternal and Newborn Clinical Care Guidelines for Uganda. MOH Uganda and other development partners put effort into training health Workers. Despite these efforts, MMR for Uganda has remained high at 189 /per 100,000 live births, with PE/E accounting for 11 per cent of these deaths. Objective: The main purpose of this study was to explore the barriers and facilitators to adherence to pre-eclampsia management guidelines among health workers at Kawempe National Referral Hospital. Method: This research employed exploratory qualitative descriptive studies which examined health workers’ experiences of barriers and facilitators to adherence to pre-eclampsia management guidelines through the descriptions provided by the people involved. It involved collecting data using in-depth interviews with health workers at a single point in time. Results: Face-to-face in-depth interviews were conducted, and observations were made for 16 health workers. The results were presented in two categories: demographic characteristics and themes that describe the barriers and facilitators to adherence to pre-eclampsia management guidelines. This research revealed that different demographic characteristics contribute to different barriers and facilitators to adherence to preeclampsia management guidelines among health workers. For example, barriers like poor documentation, knowledge gaps, poor referral systems, and poor attitudes toward health were noted more commonly among the young, less experienced and health workers of low education levels. Conclusion: The study showed that the care provided to preeclampsia mothers was not according to the prescribed standards of care. These were mainly influenced by inadequate resources, especially human resource and material resources, inadequate knowledge and a poor referral system. Recommendation: The study suggests enhancing adherence to preeclampsia management guidelines by addressing resource limitations, conducting research, exploring innovative approaches like checklists, reminders, or technology-based solutions, recording and running audios on preeclampsia, and promoting education on various media platforms. Key words: Preeclampsia, Eclampsia, Adherence to preeclampsia management guidelines