Integration of a community based management of severe pre eclampsia and eclampsia with improved governance of local government in rural Bangladesh

International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
Organization Location: 
Dhaka, Bangladesh

In Bangladesh nearly 2,000 women die from eclampsia and pre-eclampsia each year. A icddr,b study found that 24% severe preeclampsia (SPE) and eclampsia received loading MgSO4 by trained community health providers (CHP) and concluded that poor antenatal care (ANC) missed a large number of SPE. Therefore, SPE cases progressed to eclampsia and notified at later stage of pregnancy at the referral facility.  UPEHFPSC, one of the local government’s institutes in Bangladesh is neither aware about maternal health (MH) policy nor about their role to improve MH initiative. The proposed study will be based on two complementary forces – CHP and UPEHFPSC to work together in improving the SPE and eclampsia management by loading MgSO4 before referral. The study aims to improve quality ANC for case management, reduce incidence of SPE, eclampsia, thereby reduce severe maternal and neonatal outcomes. It will achieve its sustainability as local government will play their endorsed governing role over quality ANC.  Currently the existing practice is to identify high risk mothers followed by referral. Long distance of facilities is a substantial barrier to receive care at acute emergencies. Loading MgSO4 will save mothers at the height of emergency by addressing the delay in reaching facility. UPEHFPSC have never been effectively utilized in bringing about a change in community health status. The proposed research project will address the governance by UPEHFPSC over the quality ANC services.