Knowledge and skills of pre-eclampsia management among healthcare providers working in antenatal clinics in Zanzibar

Abstract

Background Pre-eclampsia and eclampsia are the leading causes of perinatal morbidity and mortality worldwide. Early detection and treatment of preeclampsia is lifesaving; however, evidence suggests that the majority of women in low and middle income-countries are not routinely screened for high blood pressure during antenatal care, that those with severe and mild pre-eclampsia are not monitored for blood pressure and proteinuria as needed, and the magnesium sulphate is not administered as needed. The purpose of this study was therefore to assess knowledge and skills in pre-eclampsia and eclampsia management and their associated factors among healthcare providers working in antenatal clinics in Zanzibar. Methods This was a cross-sectional analytical study conducted in all levels of healthcare facilities in Zanzibar. The study involved 176 healthcare providers (nurses and doctors) who were randomly selected. A self-administered questionnaire was used to collect data and descriptive and inferential statistics were used in the analysis whereby logistic regression models were employed. The Chi-square coefficient, odds ratio, and 95% confidence intervals were reported, and the level of significance was set at p < 0.05. Results The mean age of healthcare providers was 35.94 (SD ± 7.83) years. The proportion of healthcare providers with adequate knowledge was 49.0%, and 47% had adequate skills. Knowledge level was predicted by working in higher healthcare facility levels (AOR: 3.28, 95% CI: 1.29–8.29), and having attended on-the-job training on pre-eclampsia (AOR: 7.8, 95% CI: 2.74 − 22.75). Skills were predicted by having attended on-job training (AOR: 8.6, 95% CI: 2.45 − 30.16), having working experience of five years or above in antenatal care units (AOR: 27.89, 95% CI: 5.28 − 148.89) and being a medical doctor or assistant medical doctor (AOR: 18.9, 95% CI: 2.1–166). Conclusion Approximately half of Zanzibar’s ANC healthcare workers demonstrated inadequate knowledge and skills in preeclampsia care, indicating a critical need for targeted interventions to reduce maternal morbidity and mortality. Knowledge is predicted by attending on-the-job training and working in higher healthcare facility level, while skills is predicted by attending on job training, more years of working experience in antenatal care units and being a medical doctor or assistant medical doctor The study recommends the healthcare facility institutions to provide on-the-job training to for the healthcare providers working in lower healthcare facility levels.

Nurses’ Level of Knowledge on Management of Preeclampsia /Eclampsia and the Associated Factors in Northern Tanzania: An Analytical Cross-Sectional Study

“…Moreover study also showed those who get on job training as statistically significant,this was similar to study done in Zanzibar showed those get on job training had knowledge. 18 This was similar to a study conducted in Dar-es-Salaam -Tanzania, Bangladesh, and Nigeria, the result showed those who did not get on-job training have less knowledge than those who get training. Possibly the reason for similarities could be geographical location.…”

“… 16 Again, a similar study done in Bujumbura reviels knowledge gap pertaing to hypertension in pregnancy among health care providers 17 moreover study conducted in Zanzibar reviels inadequate knowledge of service providers. 18 The reason for deference in results could be; geographical location, sample size, method of analysis and type of respondents.…”

Utilization of technology to provide on-the-job trainings on Emergency Obstetric and Neonatal Care: Perspectives of nurses and midwives working in Rwanda’s remote health facilities

“…Our study found that there is a need to provide refresher trainings about maternal and neonatal complications that may occur before, during, and after childbirth. The findings from this study corroborate those of studies conducted from different low resources countries across the globe [18][19][20][21], that established the need for providing adequate and regular trainings on EmONC for nurses at primary health level to enable them recognize the risk factors of preeclampsia, and be able to confirm it so that prophylactic interventions to manage it are initiated earlier. This finding also supports the results of a similar study conducted in Rwanda that highlighted lack of regular and continuous trainings for nurses and midwives about EmONC as a constraint to managing emergency maternal and neonatal complications [21].…”

Nurses and Midwives’ Perspectives on Technology-Enhanced Learning and Continuous Professional Development on Emergency Obstetric and Neonatal Care in Rwanda

“…Particularly, our study found that there is a need to provide refresher trainings about the management of pre-eclampsia. The findings from this study corroborate those of studies conducted from different low resources countries across the globe [24][25][26][27], that established the need for providing adequate and regular trainings on EmONC for nurses at primary health level to enable them recognize the risk factors of preeclampsia, and be able to confirm it so that prophylactic interventions to manage it are initiated earlier. This finding also supports the results of a similar study conducted in Rwanda that highlighted lack of regular and continuous trainings for nurses and midwives about EmONC as a constraint to managing emergency maternal and neonatal complications including pre-eclampsia [27].…”