Knowledge levels and practices of midwives in the management of severe pre-eclampsia at health centre level

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Severe pre-eclampsia (PE) is an obstetric emergency that causes serious pregnancy complications. Zambia has one of the highest maternal and neonatal mortality rates in the sub-Saharan region, with a maternal mortality rate of 398 per 100,000 live births, with 17% due to hypertensive disorders. Midwives, who are the first contact for these pregnant women, should be knowledgeable and competent in the assessment and diagnosis of pregnant women who are at risk of developing severe PE, and be able to manage them.


The aim of this study was to explore knowledge levels and practices of midwives in the management of severe PE at health centre level.

Method and materials:

The study used a descriptive design and a structured interview schedule to determine the knowledge levels and practices of midwives from health centres in two districts (Lusaka and Luanshya) of Zambia. A total of 196 respondents were interviewed.


The results revealed that knowledge among the midwives of management of severe PE was generally medium (81%). The majority of the respondents had good levels of practice (76%) on management of severe PE. However, lack of in-service training in emergency management of obstetric complications, poor staffing levels, and lack of supervision were some of the challenges that compromised the management of clients with severe PE.


Results from this study have highlighted some gaps in the management of severe PE. Although midwives have some knowledge in the management of severe PE, lack of in-service training and inadequate human and material resources compromise management. Therefore, the government needs to strengthen support for midwives especially those in the health centres where there are no obstetricians.

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