Primary healthcare provider perspectives on hypertensive disorders of pregnancy in southwestern Uganda: a qualitative study
9 affiliations
- 1Department of Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, Uganda
- 2Division of Experimental Medicine and Immunotherapeutics, Department of Medicine, University of Cambridge, Cambridge, UK
- 3Department of Nursing, Mbarara University of Science and Technology, Mbarara, Uganda
- 4Department of Physiology, Mbarara University of Science and Technology, Mbarara, Uganda
- 5Department of Obstetrics and Gynecology, Mbarara Regional Referral Hospital, Mbarara, Uganda
- 6Department of Obstetrics and Gynecology, Kawempe National Referral Hospital, Kampala, Uganda
- 7Department of Obstetrics and Gynecology, University of Ghana medical school, Accra, Ghana
- 8Directorate of Graduate Training, Research and Innovations, Muni University, Arua, Uganda
- 9Department of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda
Abstract
Background: Hypertensive disorders of pregnancy (HDP), specifically preeclampsia and eclampsia, are leading causes of maternal and perinatal mortality in sub-Saharan Africa. In Uganda’s tiered health system, primary healthcare facilities (Health Center III and IV) serve as the frontline for early detection of HDP among women attending antenatal care (ANC). However, implementation gaps persist in these settings. This study explored the perspectives of healthcare providers (HCPs) on the practices, barriers, and facilitators regarding HDP screening, diagnosis, and management in Southwestern Uganda.
Methods: We conducted an exploratory qualitative study using in-depth interviews with 13 purposively sampled HCPs (midwives, nurses, and medical officers) across six primary health facilities in Mbarara City. Using a semi-structured interview guide, data were collected from January 2025 to March 2025. Data were analyzed using inductive thematic content analysis.
Results: Screening for HDP during ANC was primarily conducted using blood pressure measurement and urinalysis, but was frequently undermined by technical barriers such as non-functional blood pressure machines and supply constraints like stock-outs of urine dipsticks. No participants (0/13) reported the use of prophylactic aspirin for high-risk mothers. Key barriers included the absence of HDP-specific guidelines, heavy workloads, cultural and socioeconomic factors. Facilitators included routine health education sessions and the use of digital consultation via WhatsApp groups for real-time specialist support. To address these challenges, HCPs proposed potential measures such as facility-based mentorship for HCPs, the integration of mHealth decision-support tools, and redesigning ANC cards to make risk factors more visible.
Conclusions: Healthcare providers in southwestern Uganda showed strong awareness of HDP care but were constrained by unreliable equipment, supply shortages, and limited staffing. Strengthening supply chains, mentorship, and digital decision-support could enhance the capacity of primary care facilities to deliver timely HDP prevention, screening, and early diagnosis.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12913-026-15315-2.
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BibTeX
@article{lugobe2026primary,
title = {{Primary healthcare provider perspectives on hypertensive disorders of pregnancy in southwestern Uganda: a qualitative study}},
author = {Henry Mark Lugobe and Josephine Nambi Najjuma and Ian B. Wilkinson and David Collins Agaba and Leevan Tibaijuka and Alan Babweteera and Wasswa George Muganwa and Simon Tomusange and Kwame Adu-Bonsaffoh and Pius Musinguzi and Gerald Mwebembezi and Jonathan Izudi and Carmel M. Mceniery},
journal = {BMC Health Services Research},
year = {2026},
month = aug,
doi = {10.1186/s12913-026-15315-2},
url = {https://doi.org/10.1186/s12913-026-15315-2},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Primary healthcare provider perspectives on hypertensive disorders of pregnancy in southwestern Uganda: a qualitative study
AU - Henry Mark Lugobe
AU - Josephine Nambi Najjuma
AU - Ian B. Wilkinson
AU - David Collins Agaba
AU - Leevan Tibaijuka
AU - Alan Babweteera
AU - Wasswa George Muganwa
AU - Simon Tomusange
AU - Kwame Adu-Bonsaffoh
AU - Pius Musinguzi
AU - Gerald Mwebembezi
AU - Jonathan Izudi
AU - Carmel M. Mceniery
PY - 2026
DA - 2026/08/06
JO - BMC Health Services Research
DO - 10.1186/s12913-026-15315-2
UR - https://doi.org/10.1186/s12913-026-15315-2
AB - Background: Hypertensive disorders of pregnancy (HDP), specifically preeclampsia and eclampsia, are leading causes of maternal and perinatal mortality in sub-Saharan Africa. In Uganda’s tiered health system, primary healthcare facilities (Health Center III and IV) serve as the frontline for early detection of HDP among women attending antenatal care (ANC). However, implementation gaps persist in these settings. This study explored the perspectives of healthcare providers (HCPs) on the practices, barriers, and facilitators regarding HDP screening, diagnosis, and management in Southwestern Uganda. Methods: We conducted an exploratory qualitative study using in-depth interviews with 13 purposively sampled HCPs (midwives, nurses, and medical officers) across six primary health facilities in Mbarara City. Using a semi-structured interview guide, data were collected from January 2025 to March 2025. Data were analyzed using inductive thematic content analysis. Results: Screening for HDP during ANC was primarily conducted using blood pressure measurement and urinalysis, but was frequently undermined by technical barriers such as non-functional blood pressure machines and supply constraints like stock-outs of urine dipsticks. No participants (0/13) reported the use of prophylactic aspirin for high-risk mothers. Key barriers included the absence of HDP-specific guidelines, heavy workloads, cultural and socioeconomic factors. Facilitators included routine health education sessions and the use of digital consultation via WhatsApp groups for real-time specialist support. To address these challenges, HCPs proposed potential measures such as facility-based mentorship for HCPs, the integration of mHealth decision-support tools, and redesigning ANC cards to make risk factors more visible. Conclusions: Healthcare providers in southwestern Uganda showed strong awareness of HDP care but were constrained by unreliable equipment, supply shortages, and limited staffing. Strengthening supply chains, mentorship, and digital decision-support could enhance the capacity of primary care facilities to deliver timely HDP prevention, screening, and early diagnosis. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12913-026-15315-2.
SN - 1472-6963
ER -