Understanding challenges as they impact on hospital-level care for pre-eclampsia in rural Ethiopia: a qualitative study.

Robbins, T; Shennan, A; Sandall, J; Eshetu Guangul, T; Demissew, R; Abdella, A; Mayston, R; Hanlon, C

Understanding challenges as they impact on hospital-level care for pre-eclampsia in rural Ethiopia: a qualitative study.

Robbins, T Shennan, A Sandall, J

Eshetu Guangul, T Demissew, R Abdella, A Mayston, R Hanlon, C

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Publisher:: BMJ PUBLISHING GROUP
Publication Type:: Journal Article
Citation:: BMJ Open, 2023, 13, (4), pp. e061500
Issue Date:: 2023-04-17

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Field	Value	Language
dc.contributor.author	Robbins, T
dc.contributor.author	Shennan, A
dc.contributor.author	Sandall, J https://orcid.org/0000-0003-2000-743X
dc.contributor.author	Eshetu Guangul, T
dc.contributor.author	Demissew, R
dc.contributor.author	Abdella, A
dc.contributor.author	Mayston, R
dc.contributor.author	Hanlon, C
dc.date.accessioned	2023-10-04T03:34:25Z
dc.date.available	2023-10-04T03:34:25Z
dc.date.issued	2023-04-17
dc.identifier.citation	BMJ Open, 2023, 13, (4), pp. e061500
dc.identifier.issn	2044-6055
dc.identifier.issn	2044-6055
dc.identifier.uri	http://hdl.handle.net/10453/172465
dc.description.abstract	OBJECTIVE: To explore hospital-level care for pre-eclampsia in Ethiopia, considering the perspectives of those affected and healthcare providers, in order to understand barriers and facilitators to early detection, care escalation and appropriate management. SETTING: A primary and a general hospital in southern Ethiopia. PARTICIPANTS: Women with lived experience of pre-eclampsia care in the hospital, families of women deceased due to pre-eclampsia, midwives, doctors, integrated emergency surgical officers and healthcare managers. RESULTS: This study identified numerous systemic barriers to provision of quality, person-centred care for pre-eclampsia in hospitals. Individual staff efforts to respond to maternal emergencies were undermined by a lack of consistency in availability of resources and support. The ways in which policies were applied exacerbated inequities in care. Staff improvised as a means of managing with limited material or human resources and knowledge. Social hierarchies and punitive cultures challenged adequacy of communication with women, documentation of care given and supportive environments for quality improvement. CONCLUSIONS: Quality care for pre-eclampsia requires organisational change to create a safe space for learning and improvement, alongside efforts to offer patient-centred care and ensure providers are equipped with knowledge, resources and support to adhere to evidence-based practice.
dc.format	Electronic
dc.language	eng
dc.publisher	BMJ PUBLISHING GROUP
dc.relation.ispartof	BMJ Open
dc.relation.isbasedon	10.1136/bmjopen-2022-061500
dc.rights	info:eu-repo/semantics/openAccess
dc.rights	© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.
dc.subject	1103 Clinical Sciences, 1117 Public Health and Health Services, 1199 Other Medical and Health Sciences
dc.subject.classification	32 Biomedical and clinical sciences
dc.subject.classification	42 Health sciences
dc.subject.classification	52 Psychology
dc.subject.mesh	Pregnancy
dc.subject.mesh	Humans
dc.subject.mesh	Female
dc.subject.mesh	Pre-Eclampsia
dc.subject.mesh	Ethiopia
dc.subject.mesh	Quality of Health Care
dc.subject.mesh	Qualitative Research
dc.subject.mesh	Hospitals
dc.subject.mesh	Humans
dc.subject.mesh	Pre-Eclampsia
dc.subject.mesh	Pregnancy
dc.subject.mesh	Qualitative Research
dc.subject.mesh	Hospitals
dc.subject.mesh	Quality of Health Care
dc.subject.mesh	Ethiopia
dc.subject.mesh	Female
dc.subject.mesh	Pregnancy
dc.subject.mesh	Humans
dc.subject.mesh	Female
dc.subject.mesh	Pre-Eclampsia
dc.subject.mesh	Ethiopia
dc.subject.mesh	Quality of Health Care
dc.subject.mesh	Qualitative Research
dc.subject.mesh	Hospitals
dc.title	Understanding challenges as they impact on hospital-level care for pre-eclampsia in rural Ethiopia: a qualitative study.
dc.type	Journal Article
utslib.citation.volume	13
utslib.location.activity	England
utslib.for	1103 Clinical Sciences
utslib.for	1117 Public Health and Health Services
utslib.for	1199 Other Medical and Health Sciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Midwifery
utslib.copyright.status	open_access	*
dc.date.updated	2023-10-04T03:34:24Z
pubs.issue	4
pubs.publication-status	Published online
pubs.volume	13
utslib.citation.issue	4

Abstract:

OBJECTIVE: To explore hospital-level care for pre-eclampsia in Ethiopia, considering the perspectives of those affected and healthcare providers, in order to understand barriers and facilitators to early detection, care escalation and appropriate management. SETTING: A primary and a general hospital in southern Ethiopia. PARTICIPANTS: Women with lived experience of pre-eclampsia care in the hospital, families of women deceased due to pre-eclampsia, midwives, doctors, integrated emergency surgical officers and healthcare managers. RESULTS: This study identified numerous systemic barriers to provision of quality, person-centred care for pre-eclampsia in hospitals. Individual staff efforts to respond to maternal emergencies were undermined by a lack of consistency in availability of resources and support. The ways in which policies were applied exacerbated inequities in care. Staff improvised as a means of managing with limited material or human resources and knowledge. Social hierarchies and punitive cultures challenged adequacy of communication with women, documentation of care given and supportive environments for quality improvement. CONCLUSIONS: Quality care for pre-eclampsia requires organisational change to create a safe space for learning and improvement, alongside efforts to offer patient-centred care and ensure providers are equipped with knowledge, resources and support to adhere to evidence-based practice.

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http://hdl.handle.net/10453/172465