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PE/E Management Strategies at different levels. Pius Okong M.Med, PhD Associate Professor Nsambya Hospital, FIGO SM&NHC. Timely management. Elements CEmOC BEmOC Family/Co Diagnosis YES YES Recog

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Pe e management strategies at different levels

PE/E Management Strategies at different levels

Pius Okong M.Med, PhD

Associate Professor

Nsambya Hospital, FIGO SM&NHC


Timely management
Timely management

Elements CEmOC BEmOC Family/Co

  • Diagnosis YES YES Recog

  • Treat YES Initiate Cont.

  • Monitor YES YES ?

  • Plan delivery YES No No

  • Delivery YES Y/N ?


Pe e case management
PE/E Case management

  • Diagnosis

  • Prevent seizures: Min 24 hrs, Mag Sulphate

  • Control/stabilize BP: Antihypertensive IV

  • Evaluate cond. of Baby

  • Evaluate mother: LFT,RFT,CBC

  • Monitoring


Family community level
Family/Community level

Who?

  • Pregnant woman/support person

  • CHW

    What?

  • Knowledge to recognize seizures and symptoms

  • Plan for emergency, transfer to BeOC facility

    Little or No information on CHW roles? Urine testing at home? Lack of evidence Research


Basic eon care facility
Basic EON Care Facility

Who?

  • Midwives/Lab Assistant

  • Clinical officers/Nurses

    What?

  • Diagnosis: symptoms/exam/urine testing?

  • Initiate Mag Sulphate, Anti HT

  • Monitoring: BP, for seizures, fetus, urine etc

  • Communication/Transfer to CEmONC

    Evidence about early treatment beneficial


Cemonc facilities
CEmONC Facilities

Who?

  • Midwives

  • Doctors

  • Anaethetists

  • Laboratory tech


Cemonc facilities1
CEmONC Facilities

What? Processes

  • Emergency preparedness/critically ill patient

  • Drills for the teams?

  • Consumables

  • Tools

  • Use of Mag Sulphate for PE, prenatal and continuing pregnancy

    Evidence about use of Mag/sulphate and timing of delivery etc.


Challenges
Challenges

Evidence for:

  • Research to fill the gaps at community level: CHW information, diagnosis, urine testing and what medications?

  • Modeling the complex aspects of case management in health facilities

  • Case management audits: accountability and health care quality?