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Table 3 Case management: percentage of providers responding correctly to case scenario related to severe pe/e symptoms, by provider type, provider training, and facility type

From: Prevention and management of severe pre-eclampsia/eclampsia in Afghanistan

  Provider type Provider training Facility type
Correct responses to case scenario Doctors (n = 79) Midwives (n = 139) p-value Untrained providers (n = 44) Trained providers (n = 174) p-value CHCs and district hospitals (n = 43) Provincial hospitals (n = 25) Regional and specialized hospitals (n = 10) p-value
I. Information needed immediately to start emergency management (%)
Level of consciousness 92.2 83.6 0.228 80.0 89.7 0.076 80.3 93.3 90.9 0.046
Presence of current convulsions 88.4 87.3 0.949 69.4 90.5 <0.001 80.0 92.3 91.1 0.082
Vital signs 96.9 96.4 0.929 100.0 95.8 0.214 97.0 96.3 97.0 0.970
II. Diagnosis of eclampsia (%)
Diagnosis of eclampsia 77.2 62.3 0.120 66.7 67.8 1.000 60.5 66.3 81.1 0.282
III. Urgent actions to manage presenting condition (%)
Bed resta 44.3 42.5 0.725 58.3 38.2 0.019 31.4 53.7 50.0 0.008
MgSO4 96.2 88.5 0.051 82.3 93.3 0.035 87.2 92.6 94.7 0.297
IV. Immediate actions if woman is having convulsions when admitted (%)
Give oxygen at 4–6 L per min. 88.6 81.3 0.153 83.3 86.0 0.638 79.1 85.3 92.1 0.171
Place in side-lying position 88.6 85.6 0.622 77.1 87.6 0.098 83.7 92.6 78.9 0.062
Protect woman from injury 79.2 75.0 0.696 75.0 75.8 1.000 68.6 78.9 86.8 0.064
V. Essential equipment and supplies to manage most urgent condition (%)
IV with saline or Ringers Lactate 78.4 87.7 0.070 83.3 83.7 0.823 83.7 86.3 76.3 0.372
Indwelling urinary catheter/ bag 87.0 83.1 0.361 85.4 82.6 0.830 74.4 90.5 89.4 0.008
Suction and suction catheter 87.3 78.2 0.098 68.8 76.4 0.335 68.6 87.4 92.1 0.001
Oxygen and adult mask 91.1 84.2 0.142 77.1 88.8 0.049 82.6 87.4 86.8 0.633
VI. Appropriate actions after convulsions are controlled (%)
Repeat dose of MgSO4 in 4 hours 71.4 77.9 0.301 64.6 77.5 0.083 74.4 73.7 84.2 0.409
Continue anti-hypertensives 81.0 66.2 0.024 56.3 74.7 0.016 70.9 67.4 81.6 0.072
Monitor labor, begin partograph 79.2 80.9 0.532 77.3 81.4 0.672 72.1 89.5 79.0 0.262
Check respirations hourly (auscultate lungs if needed) 59.5 54.7 0.683 35.4 61.8 0.002 50.0 62.1 60.1 0.012
Document intake/output hourly 75.9 69.1 0.269 68.8 71.4 0.854 62.8 76.8 73.7 0.232
VII. Appropriate actions after vaginal delivery (%)
Continue MgSO4 for 24 hours 80.5 77.2 0.995 72.7 80.8 0.302 72.1 83.2 84.2 0.130
Assess vital signs every 15 minutes for 2 hours after birth 90.9 90.4 0.652 88.6 91.6 0.771 91.9 92.6 84.2 0.288
  1. aBed rest is interpreted as continuous care in a bed near staff until she is stable, with hourly observations thereafter.