Context
The 2023 UN Report on Trends in Maternal Mortality from 2000-2020 revealed that 1 in 19 women have a lifetime risk of dying from birth-related complications in Nigeria. In the same year, Ferring Pharmaceuticals sought to understand the gaps in addressing maternal risk factors; especially regarding the identification and management of preeclampsia and eclampsia by both patient and health care provider.
This research is pivotal in understanding the gaps in preeclampsia/Eclampsia (PE/E) identification and management in Kano state, and explore opportunities to leverage available technology to improve maternal outcomes for women and their unborn children in Nigeria.
– Eric Aigbogun Co-Investigator, Senior Engagement Manager,
SCIDaR
Opportunities
As part of efforts to support the Nigerian Government in addressing maternal mortality in Nigeria, Solina Centre for International Development and Research (SCIDaR) , with funding from Ferring Pharmaceuticals, initiated a collaborative research with the Kano State Primary Health Care Development Agency and the State Ministry of Health in addressing challenges with the identification and management of PE/E constituting a significant part of the burden.
What we did
The research used the Human-Centered Design (HCD) to understand individual and community perceptions and knowledge of pre-eclampsia/eclampsia and their impact on health service utilization and pregnancy outcomes. It also identified gaps in the identification and management of preeclampsia/eclampsia at the Health Facility (HF) level with relevant stakeholders and developed potential strategies for preventing and managing these conditions in pregnant women. The research sampled 828 expectant mothers in 16 different health facilities across two Local Government Areas: Ungogo and Kumbotso, and was conducted in Hausa language.
What we found
In July 2024, SCIDaR presented its findings to stakeholders in the state to seek viable recommendations. Dr. Imam Wada Bello, the Director of Public Health and Disease Control, made known the state government’s dedication to tackling maternal health issues..
The findings from the research show different perspectives of pre-eclampsia/eclampsia from pregnant women.
The 9-month study revealed several opportunities for improvement. Despite government efforts to make magnesium sulfate (an essential medicine for managing eclampsia) available, most of the stock at the PHC facilities remain underutilized. This situation largely stems from the fact that 98% of primary healthcare providers have not received specific training in PE/E management over the past five – ten years, impacting health worker confidence, especially at PHC levels to deliver the recommended treatment protocols. The government recognizes this challenge and is committed to enhancing training programs to better equip healthcare providers in the future.
In addition to the PHC facility and health worker readiness challenges, other demand-side barriers prevent women from accessing healthcare services for . This includes: Socio-cultural beliefs – influenced by religious beliefs and misconceptions, community related issues and family practices; financial constraints, influence of traditional medicine, and lack of trust in the health system.
Recommendations
Dr. Ibrahim Aliyu Umar, the Deputy Director training and manpower at the Ministry of Health, stressed the need for extensive sensitization efforts in Kano to address the knowledge gaps about PE/E.
He also emphasized the need to include secondary health facilities and more rural primary healthcare centers (PHCs) in the study to better understand the broader health landscape, including referral channels for PE/E and other maternal health emergencies.
Muhammad Abubakar, the Director of Research Planning and Statistics called for intensified efforts to raise community awareness of PE/E through enhanced educational campaigns and outreach programs.
Dr. Imam Wada Bello, the Director of Public Health, suggested a partnership between SCIDaR and the State Government to develop innovative capacity-building strategies, focusing on the continuous professional development of healthcare workers.