Barriers To Pre-eclampsia Incidence Reduction among Women of Somaliland-An Implementation Imbedded Qualitative Research 2016 Hussein J1,*, Ahmed KHM2, Abu-Rmeileh NME3 1Senior Lecturer of, Epidemiology and Statistics at University of Hargeisa, Somaliland 2Researcher at University of Hargeisa, Somaliland 3Director of the, Institute of Community and Public Health at Birzeit University, Palestine *Corresponding author: Hussein Jama Had, Senior Lecturer of, Epidemiology and statistics at UOH, Email: haadow@gmail.com
Online published on 18 July, 2017. Abstract Background Preeclampsia is one of the top three leading causes of Maternal death in Somaliland. Objectives: To explore challenges facing the existing monitoring and evaluation system including, preeclampsia case definition, guidelines, indicators and information flow. Methods: An in in-depth interview using purposive sampling was conducted to collect data from program managers, M&E officers and health system experts in all the six regions of Somaliland. In addition, we reviewed several documents including M&E reports, policy and strategy documents and other relevant documents. Analysis: Of the 50 target participants, 45 of them responded. Majority of the interviewees (36 out of 45) reported no specific pre eclampsia related indicators exist both in M&E tools and routine data and only few of interviewees had standardised case definition based on WHO guidelines. There is a clear linkage between data for action and quality improvements of Preeclampsia services (32 out of 45). No regular dissemination of pre-eclampsia data (34 out of 45). Majority of the participants cited that Pre-eclampsia not integrated within broader HIS and there is no political at national and sub-national levels to ensure smooth functioning of M&E for preeclampsia (44 out of 45). All the participants cited that there is no standardized protocols, guidelines, tools and instruments for preeclampsia exist. All interviewees reported that the routine reporting system has no standardized schedules for data flow and feedback at all levels and lacks standardized coding system. 38 out of 45 said that there are no M&E manuals, guidelines and protocols for data collection, processing, training and quality assurance in place. The data collection system is paper-based across the country while the reporting system is electronic at district and regional level. Conclusions To tackle pre-eclampsia barriers the government should develop a well-functioning information flow and feedback mechanisms at all levels and train RH managers, M&E and HMIS staff on standard case definition of pre-eclampsia, and harmonising information follow and feedback mechanism, proper routine recording and reporting system, analysis and interpretation of the findings. Top Keywords M&E system, Reproductive health system, Health system expert, pre-eclampsia. Top |