Determinants For Correct Diagnosis Of Preeclampsia Among Women Seeking Antenatal Services At Mbagathi County Referral Hospital Nairobi, Kenya

Abstract

Background: Preeclampsia is one of the five chief causes of maternal death. Early diagnosis greatly reduces maternal and neonatal morbidity and mortality. Guidelines have been developed in Kenya on the parameters and methods of diagnosis. However, maternal mortality and morbidity from preeclampsia in Kenya remains high. Study Objective: To assess factors that determine correct diagnosis of preeclampsia at Mbagathi county referral hospital, Nairobi, Kenya Study Design: A hospital based descriptive, cross sectional study was conducted. Both qualitative and quantitative approaches were used. Study population/ sample subjects/ procedures: The sample size was 216 antenatal women and 3 health care providers. Ethical clearance was sought from UoN/KNH ethics review committee, Nairobi County, Mbagathi hospital and the ward in charge. Informed consent was sought from the respondents. The tools were pretested at Mama Lucy Kibaki Hospital. Study area: The study was conducted in Mbagathi county referral hospital. Data collection: The data was collected using questionnaires, Key Informant Interview (KII) guide and a checklist. Data analysis and interpretation: Quantitative data was analyzed using SPSS 20.0. Qualitative data was processed through thematic analysis. It is presented through narratives. Findings: Health workers have limited knowledge of preeclampsia diagnosis particularly in timing of preeclampsia, and diagnostic criteria for urinalysis/ dipstick test. Dipsticks and guidelines on PET diagnosis were unavailable in the antenatal clinic Client knowledge on PET diagnosis is low Conclusion: Health workers have limited knowledge of diagnosis and need constant refresher courses. There is need for dipsticks and preeclampsia guidelines to be available in the antenatal clinic. Women need to be informed on Preeclampsia diagnosis Recommendations: Diagnostic criteria for preeclampsia should be reviewed, proteinuria tests done for every woman at every antenatal visit. Awareness talks given to women on preeclampsia and constant refresher updates for health care providers.