Systemic bottlenecks hinder quality health services for pregnant women and their infants.
In four districts in Bangladesh, researchers examined health providers’ knowledge, attitudes, practices, skills, and experiences in preventing, detecting, and managing pre-eclampsia/eclampsia (PE/E). They looked at providers’ understanding of risk factors, detection procedures, and signs and symptoms of PE/E, as well as lifesaving commodities, equipment, and drugs at health facilities.
- High-level facilities have written guidelines and protocols for diagnosing and managing PE/E and utilizing MgSO4, but primary facilities do not;
- All secondary facilities have registers for documenting antenatal care, postnatal care, delivery referral, patient admission, and operating-theater information. Most primary facilities have registers for documenting antenatal, postnatal, and delivery care, but few have registers for documenting admission and operating-theater information. However, proper documentation is lacking in many primary and secondary facilities;
- Only 21 percent of secondary facilities have essential equipment and drugs needed to detect and treat PE/E;
- 53 percent of secondary facilities never use MgSO4; and
- 55 percent of all facilities obtain MgSO4 from the national level, with the remaining 45 percent reporting that patients purchase it from local markets, as needed.