- Title
- Preeclampsia and eclampsia in Ethiopia: magnitude, outcomes, health facility readiness
- Creator
- Meazaw, Maereg Wagnew
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2023
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Preeclampsia and eclampsia are among the top causes of complications during pregnancy and some of the key causes of maternal morbidity and mortality. In Ethiopia, several studies showed that preeclampsia and eclampsia are among the top five causes of maternal morbidity and mortality. However, the existing information in the area of preeclampsia and eclampsia, associated risk factors, and contribution to maternal complications and neonatal outcomes at a national level are limited and inconsistent. Therefore, this thesis aims to assess the risk factors, epidemiology, and management outcomes of preeclampsia and eclampsia in Ethiopia using nationally representative data. This thesis used two main data sources: reviews and pooled analyses of literature from sub-Saharan African countries and secondary analyses of facility-based national data. A combination of systematic review and meta-analysis, mapping of cases, and descriptive analysis were applied to answer the research objectives. The risk factors for hypertensive disorder of pregnancy in general and specifically for preeclampsia and eclampsia were assessed through systematic review and meta-analysis of published articles from sub-Saharan African countries. Descriptive analysis of a medical record review and mapping of cases were employed to examine the clinical care and perinatal outcomes for women with preeclampsia and eclampsia and to assess the prevalence, management and regional distribution, respectively. According to the findings of the systematic reviews and meta-analyses, being primiparous, having a previous hypertensive disorder of pregnancy, having a family history of hypertensive disorder of pregnancy, lower maternal educational level, high maternal body mass index, experiencing another pre-existing medical condition, experiencing anaemia during pregnancy or having a lack of ANC visits were associated with the development of preeclampsia or eclampsia during pregnancy. The record review of preeclampsia/eclampsia cases showed that a high proportion of perinatal mortality was reported for women with preeclampsia/eclampsia and the majority of these deaths were reported for cases admitted to hospitals, in urban areas, referred cases from other facilities, long waiting hours before giving birth or women who had unstable vital signs during admission for birth. In general, preeclampsia/eclampsia contributed to close to 6% of all maternal complications in health facilities with the highest report from the Harari and Addis Ababa regions. However, in terms of the proportion of obstetric complications, high reports were observed from Afar, Somali, Benshangul Gumz and Harari regions. Overall, only 1% of available hospitals in the country were located in rural areas and a significant proportion of health facilities in rural areas, those that were public or government managed and health centres were poorly equipped, had limited necessary supplies and provided limited training to health professionals to screen and managed preeclampsia/eclampsia cases. The findings suggested that preeclampsia/eclampsia remain high in Ethiopia and there were notable gaps in readiness of health facilities in detection and management of preeclampsia/eclampsia. Strengthen of health care services in all aspect of maternal and child health programs in Ethiopia is needed in order to reduce maternal and perinatal complications and deaths due to preeclampsia/eclampsia.
- Subject
- preeclampsia; eclampsia; Ethiopia; health facility readiness; thesis by publication
- Identifier
- http://hdl.handle.net/1959.13/1478023
- Identifier
- uon:50082
- Rights
- Copyright 2023 Maereg Wagnew Meazaw
- Language
- eng
- Full Text
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 12 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 908 KB | Adobe Acrobat PDF | View Details Download |