Facility readiness and health workers’ knowledge in Management of preeclampsia/eclampsia among public Kampala Capital City Authority health facilities

Abstract

Background: PE/E is the second leading cause of maternal deaths with the biggest burden occurring in low resource settings. In Uganda PE/E accounts for 15% of all institutional maternal deaths reviewed. Many of the deaths are preventable with timely, accurate diagnosis and interventions to avert these deaths. This study assessed facility service readiness, and health workers’ knowledge to manage preeclampsia/Eclampsia within public KCCA facilities in Kampala. Methodology: A descriptive cross-sectional study was conducted in six (6) public KCCA health facilities in Kampala district which manage, treat, or refer mothers with PE/E. One hundred fifty-two healthcare workers from the selected health facilities in maternity department during the study period who met the eligibility criteria participated in the study. We utilized a facility observational checklist to assess the availability of 7 indicators of readiness for PE/E management and a self-administered questionnaire containing 20 questions to assess the level of knowledge. Adequate knowledge was measured as having a score of ≥80%, while a facility was considered ready to manage PE/E if it had a composite score of ≥70%. Results: The mean age of the health workers was 36.5. Generally, knowledge of PE/E among health workers was inadequate (77.3%) with variations among the different cadres. HWs had more knowledge on management of PE/E (80.9%) compared to its diagnosis, signs and symptoms and investigations (73.7%). Facility readiness yielded a mean readiness score of 63.7% (SD: 2.7). One in six facilities was the readiest to handle PE/E. 5 in 6 facilities had stockout of essential medicines to manage PE/E with Nifedipine, Methyldopa and Labetalol being the most stocked out drugs. Conclusion and recommendations: The study showed that health workers have inadequate knowledge of preeclampsia/eclampsia and the study also showed that nearly all the facilities were not ready to manage PE/E. We recommend that stakeholders address the gaps in human resources, medicines and supplies, equipment, and provider competence in PE/E management to promote a reduction in maternalmortality and morbidity from PE/E.