Blood pressure measurement takes root as lower health facilities start managing eclampsia in eastern Uganda
Without continual growth and progress, such words as improvement, achievement, and success have no meaning. – Benjamin Franklin.
If it were possible to speak to the long gone Franklin, one of the founding fathers of the United States, we would easily talk about improvement, achievement, and progress because continual progress and progress is what we are registering with our RefNet study.
RefNet, short for Referral Network, is the code name for the Strengthening health district referral networks to improve quality of maternal and early neonatal care in rural eastern Uganda study.
With a short in the arm by the WHO we are exploring the effectiveness of quality improvement (QI) and health worker capacity building approaches in reducing unnecessary referrals to Iganga Hospital and improving quality of care within the lower level health units. The study is being implemented in six sites: Iganga Hospital being the referral site, Namungalwe Health Centre III, Bugono Health Centre IV, and Busesa Health Centre IV in Iganga District; Nsinze Health Centre IV in Namutumba District and Kiyunga Health Centre IV in Luuka District.
In this blog I would like to share the story of increased uptake of best practice of taking and recording the blood pressure of pregnant mothers attending the antenatal clinic at Nsinze Health Centre.
This has enabled the health workers to detect high risk mothers to pre-eclampsia and eclampsia. Management of these cases has also been done as a result of blood pressure taking that has become routine now.
At Nsinze in particular, over 10 women have been managed for eclampsia between December 2015 and March 2016. Blood pressure is now routinely taken for all women during antenatal care visits, on admission for delivery and after delivery.
Through innovation, additional columns have been improvised in the antenatal and delivery care registers for recording blood pressure taken. This was not the practice before the start of the RefNet led quality improvement. Initially, the health workers barely paid attention to taking and recording the blood pressure of the women.
Blood pressure machines are now requested for whenever they break down. Iganga Hospital for example opted to purchase rechargeable batteries to ensure that blood pressure machines are functional all the time as opposed to when the batteries would easily run out.
Other changes (innovations) that have been tested by other study sites like Busesa include conducting CMEs on correct blood pressure taking and recording for all staff in the health facility, pinning up reminders on the walls for blood pressure taking, ensuring completeness of data entered in all patient files on admission and before discharge***
Mr Rogers Mandu is the study field coordinator for RefNet.