Readiness of public healthcare facilities on the management and referral of pre-eclampsia in Zanzibar

Abstract

Background: Proper management of pre-eclampsia/eclampsia depends on the availability of well-functioning healthcare facilities. A significant number of women with pre-eclampsia in Zanzibar are referred late and most end up with eclampsia or even death. This raised a concern about whether healthcare facilities are prepared enough for the management of pre-eclampsia/eclampsia.

Objectives: To assess the readiness of public healthcare facilities for the management and referral of pre-eclampsia/eclampsia.

Methods: A descriptive cross-sectional study was conducted in Zanzibar targeting all public healthcare facilities. A sample of 54 healthcare facilities of all levels was randomly selected. Physical observation, questionnaire and review of hospital records were used for data collection. Descriptive statistics were used for analysis.

Results: National, regional and district hospitals have all the required equipment, supplies and drugs by 100% compared to primary healthcare units where a significant shortage was observed in equipment [working oxygen cylinder 1(2.1%), strips for proteinuria 25(54.3%)], drugs [diazepam 11(23.9%) and magnesium sulphate 14(30.4%)], test [urine for protein test 29(63%)], knowledgeable healthcare providers 46(38.8%) and skilled healthcare providers 47(39.8%). All primary health care units had clear criteria for referring a patient with pre-eclampsia, but only 19(41.3%) provide pre-referral treatment and only 17(36.9%) had vehicles for transporting the referred patient.

Conclusion: There is a huge shortage of resources in lower healthcare facility levels where most pregnant women have their initial contact. Necessary measures should be taken to well-equip primary healthcare units to improve their capability to proper diagnosis, manage and timely referral of patients with pre-eclampsia.