ArticleBMJ open2021
Competency of health workers in detecting and managing gestational hypertension, pre-eclampsia, severe pre-eclampsia and eclampsia during antenatal check-ups in primary care health facilities in Bangladesh: a cross-sectional study.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prescribing patterns for hypertensive disorders of pregnancy in low- and middle-income countries: a systematic review.BMC pregnancy and childbirth · 2026Pooled it
- Correlates of antenatal care visits among expectant mothers in Malawi: application of generalised estimating equations and likelihood-based poisson and negative binomial mixed models.Reproductive health · 2026Article
- Synthesis of evidence for managing hypertensive disorders of pregnancy in low middle-income countries: a scoping review.BMC pregnancy and childbirth · 2024Article
- A WeChat-based competency and performance checklist in basic surgical skills course for military medical academy undergraduates.BMC medical education · 2022Article
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10 authors.
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Abstract
STUDY
objectiveTo evaluate the competency of trained health workers in detecting and managing hypertensive disorders of pregnancy during routine antenatal check-ups (ANCs) at primary care facilities in Bangladesh. STUDY DESIGN AND SETTINGS: Cross-sectional study; conducted in 26 primary care facilities. OUTCOME MEASURES: Accurate diagnosis of the hypertensive disorders of pregnancy.
methodIn total 1560 ANC consultations provided by primary health workers, known as Family Welfare Visitors (FWVs), were observed using a structured checklist between October 2017 and February 2018. All consultations were reassessed by study physicians for validation.
resultOf the 'true' cases of gestational hypertension (n=32), pre-eclampsia (n=29) and severe pre-eclampsia (n=16), only 3%, 7% and 25%, respectively, were correctly diagnosed by FWVs. Per cent agreement for the diagnosed cases of any hypertensive disorders of pregnancy was 9% and kappa statistics was 0.50 (p value 0.0125). For identification of any hypertensive disorders by FWVs, sensitivity and positive predictive values were 14% and 50%, respectively. There was a moderate positive correlation between the blood pressure measurements taken by FWVs and study physicians. Only 27% of those who had 'some protein' in urine were correctly identified by FWVs. Women diagnosed with any of the hypertensive disorders of pregnancy by FWVs were more likely to be counselled on at least one danger sign of pre-eclampsia (severe headache, blurring of vision and upper abdominal pain) than those without any such diagnosis (41% vs 19%, p value 0.008). All four cases of severe pre-eclampsia diagnosed by FWVs were given a loading dose of intramuscular magnesium sulphate and three among them were referred to a higher facility.
conclusionThe FWVs should be appropriately trained on risk assessment of pregnant women with particular emphasis on accurately assessing the diagnostic criteria of hypertensive disorders of pregnancy and its management.
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