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Background Preeclampsia is one of the top maternal morbidity and mortality that disproportionately affects pregnant women in low and middle-income countries where access and quality of health services are limited. People in different areas perceive preeclampsia differently which directly or indirectly affects the timing and place of heath seeking. Positive perception about perceived causes, perceived complications, and prevention of preeclampsia is central for the prediction and early diagnosis of the disease. However, little is known about the perception of pregnant women towards preeclampsia in Ethiopia. This study aimed to assess the perception towards preeclampsia and perceived barriers to early health-seeking among pregnant women in selected Hospitals of South Gondar Zone, Northwest Ethiopia. Methods A qualitative study using phenomenological approach was implemented among 20 purposively selected pregnant women who visited health facilities for antenatal care service in four selected Hospitals of the South Gondar Zone of the Amhara Region. Data were collected through an in-depth interview (IDI) using a semi-structured interview guide from January to February 2020. Thematic analysis was executed using Open Code Software version 4.03. Results The majority of the participants believed preeclampsia as a pregnancy-specific hypertensive disease and mainly associated it with overweight and nutritional problems. With regards to the perceived severity, the study participants agreed that preeclampsia can lead women to death. Personal delay, lack of awareness about the disease, transport problem, and low socioeconomic condition were perceived as the major reasons for the delay to early health-seeking (the 1st and the 2nd delay). While poor service provision and long waiting times were the barriers to receive services at the health facility level (the 3rd delay). Conclusion The majority of the participants believed preeclampsia as a pregnancy-specific hypertensive disease and mainly associated it with overweight and nutritional problems. The finding of this study implied that awareness creation about the danger of hypertension during pregnancy and its risk reduction mechanisms shall be emphasized. The care provision at health facilities shall be improved by decreasing long waiting time which discourages service utilizations aside from improving early seeking behavior of pregnant women through different interventions.
A phenomenological study approach was followed to explore the perception of pregnant women towards preeclampsia and perceived barriers to early health seeking. The study was the part of a multicenter study conducted from January to February 2020 in four selected Hospitals (Debre Tabor Hospital, Addis Zemen Hospital, Mechane Eyesus Hospital, and Nefas Mewucha Hospital) found in South Gondar Zone of the Amhara Region [19]. Pregnant women who visited the Antenatal Care (ANC) clinics of the selected hospitals were included in the study. Women who had at least one previous birth were purposively selected to better explore their perception regarding preeclampsia, its cause, perceived barriers, and perceived prevention mechanisms. Twenty pregnant women were participated in this study. Data were collected through an in-depth interview (IDI) using a semi-structured interview guide (IDI S3). The guide was prepared in the English Language following the review of various literature [14,16,17,20]. Then the guide was translated to the Amharic language which is spoken as a primary language in the study area to ease the communication process. The IDI has focused on perception towards preeclampsia, perceived causes, perceived severity, perceived consequences, perceived prevention methods, and perceived barriers to early health-seeking. The data collection process through IDI was carried out by four BSc Midwives and supervised by four MSc Clinical Midwives. The interview was conducted in a quiet and stable condition to avoid the diversion of attention until information saturation was obtained. Appropriate recording and abstraction of notes were carried out to maintain the quality of the data. The credibility and dependability of the data were maintained by continuous follow-up aside from triangulation of data in time, person, and place. The collected notes were translated into English language and reread by two independent authors. The translated notes were reviewed by all authors for correctness. Following the proofreading of the translated notes, data were organized by coding texts into meaningful elements using open code version 4.03 software. The themes and sub-themes were identified from the data using thematic analysis through the grouping of related codes. Health care-seeking behavior has been defined as any action undertaken by individuals who perceive themselves to have a health problem for finding an appropriate solution [21]. Good health-seeking was considered when the participants prefer to visit health institutions in case of an illness rather than visiting traditional healers. Perception not against the scientific base was considered as positive perception. The perception of pregnant women towards preeclampsia was reported in a descriptive manner [14]. The study was approved by the research ethics committee of the College of Health Sciences, Debre Tabor University. A support letter was also obtained from the College following the ethical approval. The study has been performed by following the Helsinki declaration. The purpose of the interview was explained to the IDI participants and written informed consent was taken from each study participant before the commencement of the interview. Permission was obtained from each hospital to conduct the study.
