A qualitative document analysis of policies influencing preeclampsia management by midwives in Ghana

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A qualitative document analysis of policies influencing preeclampsia management by midwives in Ghana


JournalWomen and Birth
Article typeJournal research article – Clinical research
Publication date – Jan – 2022
Authors – Isabella Garti, Michelle Gray, Angela Bromley, Jing-Yu (Benjamin) Tan
KeywordsMidwifery, Preeclampsia, Qualitative document analysis, Scope of practice, Standards
Open access – Yes
SpecialityObstetrics and Gynaecology
World region Western Africa
Country: Ghana
Language – English
Submitted to the One Surgery Index on February 1, 2022 at 11:41 pm
Abstract:

Background
Preeclampsia is a global issue that causes significant morbidity and mortality in low- and middle-income countries (LMICs). The care women with preeclampsia receive in LMICs is below the standard experienced by women in westernised countries due to multiple interacting factors. A review of policy factors influencing the management of preeclampsia in Ghana is needed.

Aim
This study focuses on the midwife’s role and scope of practice concerning preeclampsia management. The study aimed to explore the congruence between Ghanaian preeclampsia guidelines and international best practice recommendations for midwifery practice. The study also aimed to describe how recommendations are incorporated into Ghanaian guidelines.

Method/design
This study was a qualitative document analysis of national and tertiary hospital policies related to midwives’ scope of practice in Ghana. Altheide’s five-step process (sampling, data collection, data coding and organisation, data analysis and report) was used to systematically source and analyse the content of written documents.

Results
The findings illustrated several recommendation shortcomings in Ghanaian documents at the national and tertiary hospital levels. The content of Ghanaian preeclampsia management guidelines was not comprehensive, contained conflicting information, and was not backed by research evidence. The standards of practice for midwives were consistent at both the national and tertiary hospital levels. Midwives had limited roles in detection, management, stabilisation, and referral of women with preeclampsia.

Conclusion
Uniform guidelines incorporating international recommendations are urgently needed to improve multi-professional collaboration, solidify midwives’ roles, and optimise maternal and fetal outcomes.

OSI Number – 21473

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