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Community perceptions of the hypertensive disorders of pregnancy

University of British Columbia

Background: Two to four percent of pregnancies are affected by pre-eclampsia, the most serious of the hypertensive disorders of pregnancy. This results in a significant health burden, which disproportionately affects those in low- and middle-income countries. Research has largely focused at the facility level; however, such an approach does not address underlying beliefs and cultural practices. The aim of this dissertation is to explore community perceptions of the hypertensive disorders of pregnancy, with a focus on Nigeria, Mozambique, Pakistan and India. Methods: An ethnographic research design was used to gain insight into the perceptions and, community characteristics that relate to understanding the hypertensive disorders of pregnancy. A systematic literature review and meta-synthesis was followed by in-depth qualitative studies in Nigeria, Mozambique, Pakistan and India. A qualitative evidence synthesis to ascertain women’s comprehension of the hypertensive disorders of pregnancy was conducted using thematic synthesis of: (i) the published findings, and (ii) transcript data. All analyses were conducted following thematic analysis. CERQual (‘Confidence in the Evidence from Review of Qualitative research’) was used to present the confidence of findings. Results: Findings of this dissertation indicate gaps in knowledge regarding the hypertensive disorders of pregnancy in all regions. The literature review suggests that insufficient evidence-based information was provided by health workers to women about the hypertensive disorders of pregnancy. The knowledge of aetiology and treatment of pre-eclampsia and eclampsia were limited in Nigeria. In Mozambique and Nigeria, local beliefs associated with the supernatural, were implicated in the development and treatment of the hypertensive disorders. Overall there were mixed opinions regarding the causes of hypertension in pregnancy, and a poor understanding of the connection between these conditions and pregnancy in all regions. Qualitative syntheses revealed cultural similarities and distinct differences in the understandings of these conditions. A comparison of methods highlights the benefits of syntheses from original data, however, challenges in access and labour-intensity should be considered. Conclusions: There is a need for efforts targeted at the community to improve knowledge of the hypertensive disorders of pregnancy. Culturally-specific findings should be used as a foundation for targeted education, information, communication initiatives.

Text

2017-04-10

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/61169

Reproductive and Developmental Sciences

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/4.0/