About the project
Hypertensive disorders in pregnancy (HDP), such as pre-eclampsia (PE), affect up to 10% of all pregnancies and are currently the leading cause of maternal deaths in many countries in sub-Saharan Africa. PE alone affects 3-5% of pregnancies globally, causing 76 000 women and 500 000 infant deaths annually. In Mwanza Region, Tanzania, PE contributes to 40% of maternal deaths and has a perinatal mortality rate of 20%.
Early identification of women at risk and timely prevention and treatment of PE can greatly reduce maternal and perinatal death and disability, which is a core priority in the Sustainable Development Goals (SDG 3).
Global guidelines and models for risk-screening, prevention and management of PE exist.4 However, several health system barriers impact their implementation in low-resource settings. These include sub-standard quality of antenatal care, lack of risk screening tools, delays in referral and suboptimal management at referral hospitals. Risk screening for PE in early pregnancy is possible through measurement of biomarkers in maternal blood samples. This will allow for efficient resource allocation and targeted prevention strategies for women found to be at risk, including aspirin and calcium supplementation and timely referral if needed.
The PRESHA Project is unique in combining the promotion of novel technologies (Point of Care tests for biomarkers) with strengthening the organization of existing care processes. We will use an innovative combination of disciplines and methodological approaches to increase knowledge on the existing implementation challenges and co-create,implement and evaluate a package of interventions for prevention and management of PE, that is adapted and relevant to the Tanzanian context. Through process, impact, and cost-effectiveness evaluations we will examine how this complex intervention can be implemented successfully in Tanzania and translated to other settings.
Objectives
The three main objectives of the project are:
- To improve antenatal risk screening for onset of PE and risk of severe outcomes
- To optimize prevention and management of quality of care for women with PE
- To implement effective interventions to prevent severe adverse outcomes of PE
