Implementation challenges in preeclampsia care: perspectives from health care professionals in urban Uganda

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dc.contributor.authorNamagembe, Imelda
dc.contributor.authorKaravadra, Babu
dc.contributor.authorKazibwe, Lawrence
dc.contributor.authorRujumba, Joseph
dc.contributor.authorKiwanuka, Noah
dc.contributor.authorSmith, Brandon
dc.contributor.authorByamugisha, Josaphat
dc.contributor.authorMoffett, Ashley
dc.contributor.authorBashford, Tom
dc.contributor.authorNakimuli, Annettee
dc.contributor.authorAiken, Catherine E.
dc.date.accessioned2024-05-07T07:48:00Z
dc.date.available2024-05-07T07:48:00Z
dc.date.issued2024-05
dc.description.abstractSub-Saharan Africa bears the burden of 70% of maternal deaths worldwide, of which ∼10% are attributable to hypertensive disorders of pregnancy, primarily complications of preeclampsia. In other global settings, outcomes of pregnancies affected by preeclampsia are improved with timely and effective medical care. This study aimed to explore the perspectives of local health care professionals on how preeclampsia care is currently delivered in the study setting and what challenges they experience in providing prompt and safe care. We identified specific objectives of exploring stakeholder perceptions of (1) recognizing preeclampsia and (2) timely intervention when preeclampsia is diagnosed. We also explored the wider system factors (eg, cultural, financial, and logistic challenges) that health care professionals perceived as affecting their ability to deliver optimal preeclampsia care. Individual semistructured interviews were conducted with health care professionals and stakeholders. The findings were analyzed using thematic analysis. Thirty-three participants contributed to the study, including doctors and midwives with varying degrees of clinical experience and external stakeholders. The following 5 key themes emerged: delayed patient presentation, recognizing the unwell patient with preeclampsia, the challenges of the existing triage system, stakeholder disconnect, and ways of learning from each other. Health care professionals referenced an important psychosocial perspective associated with preeclampsia in the study setting, which may influence the likelihood of seeking care through traditional healers rather than hospital-based routes. We identify the key barriers to improving maternal and neonatal outcomes of preeclampsia, described at both the institutional level and within the wider setting. The study provides invaluable contextual information that suggests that a systems-based approach to health care quality improvement may be effective in reducing rates of maternal and neonatal morbidity and mortality.en_US
dc.identifier.citationNamagembe, Imelda, Babu Karavadra, Lawrence Kazibwe, et al. 'Implementation Challenges in Preeclampsia Care: Perspectives from Health Care Professionals in Urban Uganda', AJOG Global Reports, vol. 4/no. 2, (2024), pp. 100348-100348.en_US
dc.identifier.issnISSN 2666-5778
dc.identifier.issnEISSN 2666-5778
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/9514
dc.language.isoenen_US
dc.publisherElsevier Incen_US
dc.subject: focus groups, health care, obstetrics, maternal health, morbidity, mortality, multidisciplinary, preeclampsia, quality improvement, resources, thematic analysis, Ugandaen_US
dc.titleImplementation challenges in preeclampsia care: perspectives from health care professionals in urban Ugandaen_US
dc.typeArticleen_US
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