Abstract:
Background: Mozambique has drastically improved an array of health indicators in recent years, including maternal
mortality rates which decreased 63 % from 1990–2013 but the rates still high. Pre-eclampsia and eclampsia constitute the
third major cause of maternal death in the country. Women in rural areas, with limited access to health facilities are at
greatest risk. This study aimed to assess the current state of knowledge and the regular practices regarding pre-eclampsia
and eclampsia by community health workers in southern Mozambique.
Methods: This mixed methods study was conducted from 2013 to 2014, in Maputo and Gaza Provinces, southern
Mozambique. Self-administered questionnaires, in-depth interviews and focus group discussions were conducted with
CHWs, district medical officers, community health workers’ supervisors, Gynaecologists-Obstetricians and matrons.
Quantitative data were entered into a database written in REDCap and subsequently analyzed using Stata 13. Qualitative
data was imported into NVivo10 for thematic analysis.
Results: Ninety-three percent of CHW had some awareness of pregnancy complications. Forty-one percent were able to
describe the signs and symptoms of hypertension. In cases of eclampsia, CHWs reported to immediately refer the women.
The vast majority of the CHWs surveyed reported that they could neither measure blood pressure nor proteinuria (90 %).
Fewer reported confidence in providing oral antihypertensives (14 %) or injections in pregnancy (5 %). The other community
health care providers are matrons. They do not formally offer health services, but assists pregnant women in case of an
emergency. Regarding pre-eclampsia and eclampsia, matrons were unable to recognise these biomedical terms.
Conclusions: Although CHWs are aware of pregnancy complications, they hold limited knowledge specific to pre-eclampsia
and eclampsia. There is a need to promote studies to evaluate the impact of enhancing their training to include additional
content related to the identification and management of pre-eclampsia and eclampsia.
