An accurate semiautomated oscillometric blood pressure device for use in pregnancy (including pre-eclampsia) in a low-income and middle-income country population

Nathan, Hannah L.; Greeff, Annemarie de; Hezelgrave, Natasha L.; Chappell, Lucy C; Shennan, Andrew

doi:10.1097/mbp.0000000000000086

Cited by 67 publications

(90 citation statements)

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“…An important advance in the move toward offering every pregnant woman accurate BP measurement and detection of pregnancy hypertension has been the development of the semi-automated Microlife BP 3AS1-2 sphygmomanometer®, which has been validated in women with the hypertension of pre-eclampsia [69]. This device avoids the errors intrinsic in manual BP measurement in pregnancy (especially terminal digit preference [70], can be used by minimally trained community-level healthcare providers and costs less than $25 USD per unit.…”

Section: Medical Solutionsmentioning

confidence: 99%

Preventing deaths due to the hypertensive disorders of pregnancy

Dadelszen

Magee

2016

Best Practice & Research Clinical Obstetrics & Gynaecol

119

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In this chapter, taking a life cycle and both civil society and medically oriented approach, we will discuss the contribution of the hypertensive disorders of pregnancy (HDPs) to maternal, perinatal and newborn mortality and morbidity. Here we review various interventions and approaches to preventing deaths due to HDPs and discuss effectiveness, resource needs and long-term sustainability of the different approaches. Societal approaches, addressing sustainable development goals (SDGs) 2.2 (malnutrition), 3.7 (access to sexual and reproductive care), 3.8 (universal health coverage) and 3c (health workforce strengthening), are required to achieve SDGs 3.1 (maternal survival), 3.2 (perinatal survival) and 3.4 (reduced impact of non-communicable diseases (NCDs)). Medical solutions require greater clarity around the classification of the HDPs, increased frequency of effective antenatal visits, mandatory responses to the HDPs when encountered, prompt provision of life-saving interventions and sustained surveillance for NCD risk for women with a history of the HDPs.

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Section: Medical Solutionsmentioning

confidence: 99%

Preventing deaths due to the hypertensive disorders of pregnancy

Dadelszen

Magee

2016

Best Practice & Research Clinical Obstetrics & Gynaecol

119

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“…In addition, two focus groups were held with community health care workers during delivery of the intervention in local language. This second set of focus groups was used to assess the competency and experience of health workers with the Microlife VSA blood pressure device [20]. …”

Section: Resultsmentioning

confidence: 99%

A process evaluation plan for assessing a complex community-based maternal health intervention in Ogun State, Nigeria

Sharma

Adetoro

Vidler

et al. 2017

BMC Health Serv Res

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BackgroundDespite increased investment in community-level maternal health interventions, process evaluations of such interventions are uncommon, and can be instrumental in understanding mediating factors leading to outcomes. In Nigeria, where an unacceptably number of maternal deaths occur (maternal mortality ratio of 814/100,000 livebirths), the Community Level Interventions for Pre-eclampsia (CLIP) study (NCT01911494) aimed to reduce maternal and neonatal mortality and morbidity with a complex intervention of five interrelated components. Building from previous frameworks, we illustrate a methodology to evaluate implementation processes of the complex CLIP intervention, assess mechanisms of impact and identify emerging unintended causal pathways.MethodsThe study was conducted from 2013–2016 in five Local Government Areas in Ogun State, Nigeria. A six-step approach was developed to evaluate key constructs of context (external factors related to intervention), implementation (fidelity, dose, reach, and adaption) and mechanisms of impact (unintended outcomes and mediating pathways). The steps are: 1) describing the intervention by a logic model, 2) defining acceptable delivery, 3) formulating questions, 4) determining methodology, 5) planning resources in context, lastly, step 6) finalising the plan in consideration with relevant stakeholders.ResultsQuantitative data were collected from 32,785 antenatal and postnatal visits at the primary health care level, from 66 community engagement sessions, training assessments of community health workers, and standard health facility questionnaires. Forty-three focus group discussions, 38 in-depth interviews, and 23 structured observations were conducted to capture qualitative data. A total of 103 community engagement reports and 182 suspected pre-eclampsia case reports were purposively collected. Timing of data collection was staggered to understand feedback mechanisms that may have resulted from the delivery of the intervention. Data will be analysed using R and NVivo. Diffusions of innovations and realist evaluation theories will underpin analysis of the interaction between context, mechanisms and outcomes.ConclusionThis comprehensive approach can serve as a guide for researchers and policy makers to plan the evaluation of similar complex health interventions in resource-constrained settings, and to aid in measuring 'effectiveness' of interventions and not just 'efficacy'.Trial registrationThis research is a part of the Community Level Interventions for Pre-eclampsia Study, NCT01911494. The trial is registered in Clinicaltrials.gov, the URL is https://clinicaltrials.gov/ct2/show/NCT01911494 The trial was registered on June 28, 2013 and the first participant was enrolled for intervention on March 1, 2014.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2124-4) contains supplementary material, which is available to authorized users.

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“…This color‐coded light system can provide a trigger for untrained staff to act on abnormal findings. Measurements made by this device have been validated and found to meet WHO standards for use among pregnant women and in under‐resourced settings …”

Section: A Validated Automated Blood Pressure Monitormentioning

confidence: 99%

“…Measurements made by this device have been validated and found to meet WHO standards for use among pregnant women and in under-resourced settings. 3 The device was evaluated by healthcare workers and pregnant women in India, Mozambique, Nigeria, and South Africa, where it was found to be easy to use, and the traffic-light system was seen as…”

Section: A Validated Automated Blood Pressure Monitormentioning

confidence: 99%

Affordable and low‐maintenance obstetric devices

Ayres‐de‐Campos

Stones

Theron

2019

Intl J Gynecology & Obste

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Objective Adequate obstetric care requires the availability of essential diagnostic and management equipment; however, for centers with budget restrictions, the acquisition and maintenance of these devices can pose major challenges. The purpose of the present paper is to disseminate knowledge about the availability of affordable and low‐maintenance obstetric devices, which might help to save lives in low‐ and medium‐resource countries. Method Over the course of 2015–2018, the International Federation of Gynecology and Obstetrics (FIGO) Safe Motherhood and Newborn Health Committee acquired information from different clinical and commercial sources regarding the availability of affordable and low‐maintenance essential obstetric devices. Results The Committee identified several devices that met the criteria of low cost and ease of maintenance: a winding handheld Doppler device for intermittent auscultation; a portable continuous fetal heart rate monitor; a validated semi‐automated blood pressure monitor; the Foley catheter balloon for labor induction in women with an unfavorable cervix; reusable metal and plastic vacuum cups and manual pumps; an intrauterine tamponade balloon; and the non‐pneumatic anti‐shock garment. Conclusion Several affordable and low‐maintenance obstetric devices are currently available that offer the potential to save lives in resource‐constrained settings.

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An accurate semiautomated oscillometric blood pressure device for use in pregnancy (including pre-eclampsia) in a low-income and middle-income country population

Cited by 67 publications

References 0 publications

Preventing deaths due to the hypertensive disorders of pregnancy

Preventing deaths due to the hypertensive disorders of pregnancy

A process evaluation plan for assessing a complex community-based maternal health intervention in Ogun State, Nigeria

Affordable and low‐maintenance obstetric devices

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