Perceptions on preeclampsia and eclampsia among older women in rural southwestern Uganda

Abstract

Background: Eclampsia is among the leading causes of maternal mortality. It is a serious hypertensive (HT) complication of pregnancy and increases the risk of cardiovascular disease (CVD) in later life. Pregnancy-related HT complications predispose to chronic hypertension and premature heart attacks. A significant proportion of women with preeclampsia/eclampsia does not reach the formal healthcare system or arrive too late because of certain traditional or cultural beliefs about the condition. The older senior women in the community are knowledgeable and play a significant role in decision making regarding where mothers should seek maternal health care. Therefore, the purpose of this study was to explore the perceptions of older women regarding the manifestation of, risk factors and possible causes of preeclampsia/eclampsia. Methods: We conducted a qualitative study in a rural area in southwestern Uganda. The key informants were older women including community elders, village health team members and traditional birth attendants who were believed to hold local knowledge and influence on birth and delivery. We purposively selected key informants (KI) and data were collected till we reached saturation point. We analyzed data using a combined inductive and deductive approach to identify themes. Analysis was completed using N-Vivo version 12. Results: We interviewed 20 key informants. Four themes emerged namely: local name, causes and risk factors, remedies, and effects of preeclampsia/eclampsia. There was no identifiable local name from the interviews. Women carried several myths regarding the cause and these included little blood, witchcraft, stress from relations including marital tension and ghost attacks. The remedies identified included corrective nutrition, herbal treatment and prayers. Women were generally aware of the outcomes of eclampsia; mainly that it kills. Conclusion: Eclampsia is associated with significant myths and misconceptions in this rural community. We recommend interventions to increase awareness and dispel the myths and misconceptions regarding eclampsia, increase access to antenatal preeclampsia surveillance, and facilitate timely referral for basic maternity care as means for early detection and management of preeclampsia.