MATTU UNIVERSITY

COLLEGE OF HEALTH SCIENCE

DEPARTMENT OF PHARMACY

ASSESSMENT OF MAGNITUDE OF PRE-ECLAMPSIA AND

ASSOCIATED FACTORS AMONG WOMEN ATTENDING DELIVERY
SERVICE IN MATTU KARL COMPREHENSIVE SPECIALIZED
HOSPITAL SOUTHWESTERN, ETHIOPIA

BY: ADAMU MOTI

A RESEARCH PROPOSAL TO BE SUBMITTED TO MATTU

UNIVERSITY, COLLEGE OF HEALTH SCIENCES, DEPARTMENT OF
PHARMACY FOR THE PARTIAL FULFILMENT OF THE
REQUIREMENTS FOR THE BACHELOR'S DEGREE IN PHARMACY
(B. PHARM)

APRIL 2023
MATTU, ETHIOPIA
ASSESSMENT OF MAGNITUDE OF PRE-ECLAMPSIA AND ASSOCIATED
FACTORS AMONG WOMEN ATTENDING DELIVERY SERVICE IN
MKCSH SOUTHWEST, ETHIOPIA

BY: ADAMU MOTI

ADVISOR: Mr.

A RESEARCH PROPOSAL TO BE SUBMITTED TO MATTU UNIVERSITY,

COLLEGE OF HEALTH SCIENCES, DEPARTMENT OF PHARMACY FOR
THE PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE
BACHELOR'S DEGREE IN PHARMACY (B. PHARM)

APRIL 2023
MATTU, ETHIOPIA

i
Acknowledgment
First, I would like to thank the Almighty God for his love and kindness in bestowing my health,
strength, patience, and protection throughout my work. Next, I would like to forward my
gratitude to Mattu University, College of Health Science Department of Pharmacy that
providing me with this opportunity. Furthermore, I would like to express my gratitude to my
teacher and advisor, Mr. X (MSc. In …) for his guidance, support, and his continuous
enthusiasm and encouragement throughout the research proposal. I pay respect and express
appreciation to him because of his guidance, advice, consistent supervision as well as moral
support.

ii
Summary
Introduction: Preeclampsia is a serious medical complication that affects pregnant women and
their unborn babies. Even though preeclampsia is a leading cause of maternal morbidity and
mortality during pregnancy, labor, and delivery little is known about the current prevalence of
preeclampsia, and its associated factors among women attending delivery services in Ethiopia
and particularly in the study areas. Identifying the magnitude and associated risk factors of this
condition is crucial in developing effective preventive and management strategies to reduce the
burden of this life-threatening condition.
Objective: The objective of this study will be to assess the magnitude of pre-eclampsia and
associated factors among women attending delivery services in Mattu Karl Comprehensive
Specialized Hospital, Mattu, Ethiopia, 2023.
Methods: An Institutional based Cross-sectional study will be conducted starting from May 22
to June 18, 2023, at MKCSH in Mattu, Southwest Ethiopia. All women whose ages are between
eighteen and forty-five attending delivery service during the study period will be involved.
The data will be checked for completeness and consistency, and the collected data will code
and entered Epi Info version 7.2.5.0 and will be analyzed by using Statistical package for social
science (SPSS) version 27. The result is going to be compiled with table and frequency and a
conclusion will be made and a recommendation will be forwarded.
Work plan & Budget: The research will be conducted from May 22 to June 18, 2023, G.C.
Total estimated budget required to accomplish my tasks will be ETB 24,828.10 (twenty-four
thousand, eight hundred twenty-eight birr and ten cents).
Keywords: Preeclampsia, Magnitude, Factors, Delivery, Women, Ethiopia

iii
Acronyms
BMI: Body Mass Index
EDHS; Ethiopian Demographic Health Survey
LNMP: Last Normal Menstrual Period
MKCSH: Mattu Karl Comprehensive Specialized Hospital
PHI: pregnancy-induced hypertension
SPSS: Statistical Product and Service Solutions
WHO: World Health Organization

iv
 Table of Contents
Contents Page

Acknowledgment ....................................................................................................................... ii
Summary ................................................................................................................................... iii
Acronyms .................................................................................................................................. iv
List of Tables ............................................................................................................................ vii
1. INTRODUCTION .............................................................................................................. 8
1.1. Background .................................................................................................................. 8
1.2. Statement of the problem ............................................................................................. 9
1.3. Significance of the study ........................................................................................... 10
2. LITERATURE REVIEW ................................................................................................. 11
3. OBJECTIVES ................................................................................................................... 14
3.1. General objective ....................................................................................................... 14
3.2. Specific objectives ..................................................................................................... 14
4. METHODS ....................................................................................................................... 15
4.1. Study Design.............................................................................................................. 15
4.2. Study Area and study period ..................................................................................... 15
4.3. Population .................................................................................................................. 15
4.3.1. Source population .................................................................................................. 15
4.3.2. Study population .................................................................................................... 15
4.4. Sample size and sampling technique ......................................................................... 15
4.4.1. Sample size ............................................................................................................ 15
4.4.2. Sampling technique ................................................................................................ 16
4.5. Inclusion and Exclusion criteria ................................................................................ 16
4.5.1. Inclusion criteria .................................................................................................... 16
4.5.2. Exclusion criteria ................................................................................................... 16
4.6. Study variables .......................................................................................................... 16
4.7. Data collection ........................................................................................................... 17
4.8. Data quality Control .................................................................................................. 17
4.9. Data processing and analysis ..................................................................................... 17
4.10. Operational definition ............................................................................................ 17
4.11. Ethical consideration .............................................................................................. 18

v
 4.12. Dissemination of results ......................................................................................... 18
5. Work plan and Budget Plan .............................................................................................. 19
5.1. Work Plan ...................................................................................................................... 19
5.2. Budget Plan ................................................................................................................... 20
References ................................................................................................................................ 21
ANNEXES ............................................................................................................................... 23

vi
List of Tables
Table 1: Gantt Chart showing the activities that will be performed and the responsible body
with the schedule. ..................................................................................................................... 19
Table 2: List of Budgets That will be required to accomplish the task (Stationary, personal
cost, and another budget) ......................................................................................................... 20

vii
 1. INTRODUCTION

1.1. Background
Preeclampsia, sometimes referred to as toxemia or pregnancy-induced hypertension (PIH), is a
disorder that occurs during pregnancy and affects both the mother and the fetus. It is a rapidly
progressive condition characterized by elevated blood pressure, swelling, and protein in the
Urine, and one of the driving causes of maternal and perinatal horribleness and mortality (1).
Preeclampsia may develop from 20 weeks gestation. Its progress differs among patients; most
cases are diagnosed pre-term. Preeclampsia may also occur up to six weeks postpartum. Apart
from a cesarean section or induction of labor, there is no known cure. It is the most common
dangerous pregnancy complication; it may affect both the mother and the unborn child (2).
It is a syndrome characterized by the new onset of elevated blood pressure (>140/90) plus
proteinuria in a previously normotensive woman. If preeclampsia is undetected early and left
untreated, it may advance into severe life-threatening condition eclampsia characterized by the
development of convulsion, which is one of the top five direct causes of maternal mortality and
infant adverse outcome (2).
Preeclampsia refers to a set of symptoms rather than any causative factors, and there are many
different causes for the condition. It appears likely that there are substances from the placenta
that can cause endothelial dysfunction in the maternal blood vessels of susceptible women.
While blood pressure elevation is the most visible sign of diseases, it involves generalized
damage to the maternal endothelium, kidney, and liver, with the release of vasoconstrictive
factors being secondary to the original damage (3; 4).
The exact cause of preeclampsia is not fully understood, but it is believed to be related to the
abnormal development of the blood vessels in the placenta, which can lead to reduced blood
flow to the fetus and inadequate oxygen and nutrient delivery. This can cause damage to organs
such as the liver, kidneys, and brain, and lead to complications such as eclampsia (seizures),
HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count), placental
abruption, fetal growth restriction (5).
Preeclampsia can develop suddenly and progress rapidly, which is why regular prenatal care
and monitoring are crucial. It is usually diagnosed through regular blood pressure and urine
tests during prenatal visits, as well as other tests such as blood tests, ultrasounds, and fetal
monitoring (3).

8
Treatment for preeclampsia typically involves close monitoring of the mother and fetus,
medications to lower blood pressure and prevent seizures, and delivery of the baby if the
condition becomes severe or the pregnancy has reached full term. Early detection and
management of preeclampsia can significantly reduce the risk of complications for both the
mother and the baby (5).

1.2. Statement of the problem

Preeclampsia is a serious medical complication that affects pregnant women and their unborn
babies. It is a leading cause of maternal and fetal morbidity and mortality worldwide. Despite
advances in medical research and healthcare delivery, the prevalence and associated risk factors
of preeclampsia remain poorly understood, particularly in low- and middle-income countries.
Therefore, there is a need for a comprehensive assessment of the magnitude and associated
factors of preeclampsia among pregnant women in these settings to inform evidence-based
interventions and reduce the burden of this life-threatening condition (6).
Globally, Pre-eclampsia complicates about 10% of pregnancies and has remained a significant
public health problem in both developed and developing countries resulting in high maternal
and perinatal morbidity and mortality (7). However, the burden of the problem is severely high
in developing countries where, unlike other more prevalent causes of maternal mortality (such
as hemorrhage and sepsis), medical interventions may be ineffective due to the late presentation
of cases (8). In Africa and Asia, this hypertensive disorder accounts for one-tenth of all maternal
mortalities, whereas one-quarter of maternal deaths in Latin America have been associated with
preeclampsia complications (9).
As estimated by WHO, the occurrence of preeclampsia is seven times higher in developing
countries compared to developed countries. Preeclampsia during pregnancy is one of the
leading causes of maternal mortality and morbidity among pregnant women in our country (10).
Ethiopia is one of the African countries highly affected by maternal death which accounts for
about 4.8% (14, 000) of the global share in 2017 (11). According to the Ethiopian Demographic
Health Survey (EDHS) 2016 data, the maternal mortality ratio is 412 per 100,000 live births,
and hypertensive disorders have a myriad role in this maternal death (12).
Most deaths related to preeclampsia are preventable through the provision of timely
identification, detection, and effective treatment of women presenting with the problem.
Improving the healthcare system to prevent and treat women with hypertensive disorders is an
essential step toward minimizing maternal and infant morbidity and mortality (13).

9
 1.3. Significance of the study
Preeclampsia is a major public health concern that contributes significantly to maternal and
fetal morbidity and mortality globally. Identifying the magnitude and associated risk factors of
this condition is crucial in developing effective preventive and management strategies to reduce
the burden of this life-threatening condition. Understanding the epidemiology of preeclampsia
and its associated factors is particularly important in low- and middle-income countries where
the prevalence of the condition is high, and resources for maternal and fetal healthcare are often
limited.
The government of Ethiopia has implemented multi-pronged approaches to reducing maternal
and newborn morbidity and mortality by improving access to and strengthening facility-based
maternal and newborn services. However, maternal morbidity and mortality due to hypertensive
disorders are still on an alarming trend (14).
Even though preeclampsia is a leading cause of maternal morbidity and mortality during
pregnancy, labor, and delivery little is known about the current prevalence of preeclampsia, and
its associated factors among women attending delivery services in Ethiopia and particularly in
the study areas. Therefore, this study is intended to assess the magnitude of preeclampsia and
its associated factors among women attending delivery in the Mattu Karl Comprehensive
Specialized Hospital. This study will provide valuable information on the prevalence and
associated risk factors of preeclampsia among pregnant women in a particular setting, which
can be used to inform policy and practice in maternal and fetal healthcare. The findings of this
study can be useful to healthcare providers, policymakers, and stakeholders involved in
improving maternal and fetal health outcomes. Additionally, the study may also provide a
foundation for future research in the area of preeclampsia, especially in similar settings.

10
2. LITERATURE REVIEW
2.1. Introduction
Pre-eclampsia is a pregnancy complication characterized by hypertension and proteinuria that
usually arises after 20 weeks of gestation in a previously normotensive and non-proteinuria
woman. It is a leading cause of maternal and fetal morbidity and mortality worldwide (6).
According to the World Health Organization (WHO), pre-eclampsia complicates around 10%
of pregnancies globally (7). The incidence of pre-eclampsia varies among populations and is
influenced by various factors, including maternal age, parity, and body mass index (BMI),
among others. Early detection and management of pre-eclampsia are crucial to reduce maternal
and fetal morbidity and mortality.

Several studies have been conducted to determine the magnitude of pre-eclampsia among
women attending delivery services. A study conducted in Nigeria found that the prevalence of
pre-eclampsia was 8.8% (15). In Tanzania, a study reported a prevalence of 7.3% (16), while
another study in Ethiopia reported a prevalence of 15.7% in Debre Tabor Comprehensive
Specialized Hospital , 12.4% in Mettu (17), 7.9% in Mizan Tepi (18). These findings suggest
that the prevalence of pre-eclampsia varies widely among different populations.

2.2. Sociodemographic and Obstetrics Factors

2.2.1. Socio-demographic factors

Several socio-demographic factors have been identified as risk factors for pre-eclampsia. A
study conducted in Nigeria found that maternal age above 35 years, low educational level, and
low socio-economic status were significantly associated with pre-eclampsia (15). Similarly, a
study in Ghana reported that low maternal education, low socio-economic status, and nulliparity
were significantly associated with pre-eclampsia (16).

2.2.2. Obstetric factors

Several obstetric factors have also been identified as risk factors for pre-eclampsia. A study in
Ethiopia found that primigravida, multiple gestation, and history of pre-eclampsia were
significantly associated with pre-eclampsia (19). Another study conducted in Tanzania reported
that twin pregnancy, history of pre-eclampsia, and history of gestational diabetes were
significantly associated with pre-eclampsia (16).

Furthermore, a study conducted in Nigeria found that history of preterm delivery, history of
stillbirth, and history of infertility were significantly associated with pre-eclampsia (15).

11
Similarly, a study in Zanzibar reported that history of pre-eclampsia, history of stillbirth, and
history of preterm delivery were significantly associated with pre-eclampsia (20).

2.3. Knowledge and Awareness Factors

Early detection and management of pre-eclampsia are crucial to reduce adverse outcomes, but
this depends on women's knowledge and awareness of the condition.

Several studies have investigated the knowledge and awareness of pre-eclampsia among
women attending delivery services. In a cross-sectional study conducted in Nigeria, only 28%
of women knew about pre-eclampsia, and only 13% knew its signs and symptoms. Another
study in Ghana reported that only 37.6% of women knew about pre-eclampsia, and only 15.8%
knew its signs and symptoms (21). Similarly, a study in Ethiopia found that only 28.8% of
women had a good knowledge about pre-eclampsia, and 7% knew its signs and symptoms (22).

The low level of knowledge and awareness of pre-eclampsia among women attending delivery
services is a concern. This is because women who are unaware of pre-eclampsia may not
recognize its signs and symptoms and may delay seeking care, which can lead to severe
complications and death. Moreover, women who are not informed about pre-eclampsia may not
take preventive measures or follow recommended management practices.

Studies have identified several factors that influence women's knowledge and awareness of pre-
eclampsia. These include maternal education, age, parity, socioeconomic status, and access to
healthcare. For instance, studies have found that women with higher levels of education, older
women, and women with more pregnancies have better knowledge and awareness of pre-
eclampsia. In contrast, women with low socioeconomic status and limited access to healthcare
are less likely to know about pre-eclampsia (21).

Interventions to improve women's knowledge and awareness of pre-eclampsia include antenatal

education, community-based education programs, and healthcare provider training. Antenatal
education can provide women with information about pre-eclampsia and its signs and
symptoms, as well as prevention and management strategies (23). Community-based education
programs can also improve women's knowledge and awareness of pre-eclampsia by engaging
community health workers and local leaders. Healthcare provider training can ensure that
healthcare providers have the knowledge and skills to identify and manage pre-eclampsia.

12
 2.4. Screening and Management Practices
Several screening and management strategies have been developed and implemented to
improve the care of women with pre-eclampsia. Screening for pre-eclampsia typically involves
measuring blood pressure and proteinuria during antenatal care visits. Some screening tools
also incorporate other clinical and laboratory parameters, such as maternal age, body mass
index, gestational age, and blood tests for biomarkers such as placental growth factor and
soluble films-like tyrosine kinase-1. The choice of screening tool depends on various factors,
including the availability of resources, the local prevalence of pre-eclampsia, and the healthcare
provider's expertise (5).
Management of pre-eclampsia typically involves close monitoring of maternal and fetal status,
administration of medications such as antihypertensives and magnesium sulfate, and timely
delivery. The timing and mode of delivery depend on various factors, including the severity of
pre-eclampsia, gestational age, fetal status, and maternal condition. Women with severe pre-
eclampsia or eclampsia often require hospitalization and close monitoring and may need to be
delivered urgently to prevent further complications (2).
Several guidelines and protocols have been developed to standardize the screening and
management of pre-eclampsia. For instance, the World Health Organization recommends that
all pregnant women have their blood pressure measured at every antenatal care visit, and that
women with suspected pre-eclampsia or eclampsia be referred to a higher-level facility for
appropriate management. The American College of Obstetricians and Gynecologists
recommends that women with severe pre-eclampsia or eclampsia be delivered promptly,
regardless of gestational age (2).
Despite the availability of screening and management guidelines, the implementation of these
strategies in clinical practice remains variable. Studies have identified several barriers to the
uptake of evidence-based practices, including healthcare provider knowledge and attitudes,
limited resources, and patient factors such as lack of awareness or adherence to treatment (21).
Interventions to improve the implementation of screening and management practices for pre-
eclampsia include provider education, use of clinical decision support tools, and quality
improvement initiatives. Provider education can improve healthcare provider knowledge and
attitudes towards pre-eclampsia and increase adherence to guidelines. Clinical decision support
tools can assist healthcare providers in the timely identification and management of pre-
eclampsia. Quality improvement initiatives can improve the overall quality of care and patient
outcomes.

13
3. OBJECTIVES
3.1. General objective
✓ To assess the magnitude of pre-eclampsia and associated factors among women
attending delivery service in MKCSH, Mattu, South-west Ethiopia, 2023.

3.2. Specific objectives

✓ To assess the magnitude of preeclampsia among women attending delivery service in
MKCSH, 2023.
✓ To find out possible causes of preeclampsia among pregnant women in MKCSH, 2023.
✓ To determine the risk factors and complications of preeclampsia among pregnant
women in MKCSH, 2023.

14
 4. METHODS
4.1. Study Design
This study will utilize a facility-based cross-sectional study design to assess the magnitude of
pre-eclampsia and associated factors among women attending delivery services in MKCSH,
Mattu, South-west Ethiopia.

4.2. Study Area and study period

The study will be conducted from May 22 to June 18, 2023, G.C in Mattu Karl Comprehensive
Specialized Hospital (MKCSH). MKCSH is one of the oldest public hospitals in the country.
Geographically, located in the Ilu A/Bora zone of the Oromia Region along the Sor River,
Southwest Ethiopia in Mattu town 600 km southwest of Addis Ababa. Currently, it is the only
teaching and referral hospital in the southwestern part of the country.

4.3. Population

4.3.1. Source population

All women whose ages will be between eighteen (18) and forty-five (45) admitted to MKCSH.

4.3.2. Study population

The study population will comprise of women attending delivery services in MKCSH during
the study period.

4.4. Sample size and sampling technique

4.4.1. Sample size

The sample size is determined by the single population proportion formula by taking a
prevalence rate of 15.7%, which is the Magnitude of preeclampsia in Debre Tabor Specialized
Hospital (), Therefore, the maximum sample size can be calculated using a single proportion
estimate.

(𝑍𝛼/2)2 𝑃𝑞
𝑛=
𝑑2

Where: -
n= required sample size
α= confidence interval=95%
p= population proportion (15.7%)

15
 q=1-p
d= desired precision=5%
Zα/2 =value under the standard normal table for the given value of confidence level=1.96
(1.96)2 (0.157)(0.843)
𝑛=
(0.05)2
(3.8416)(0.1324)
𝑛=
(0.0025)
𝑛 = 203
Considering a 10% nonresponse rate, we calculated the final sample size to be;
Final sample size(nf)=203+ (203*0.1)
Nf=223, So, the total sample size will be=223.
Thus, a simple random sampling technique will be performed to select 223 study participants.

4.4.2. Sampling technique

Systematic random sampling will be conducted to recruit the study participant. We will obtain
the total number of deliveries during the study period from the hospital's delivery register and
divide it by the sample size to obtain the sampling interval. So, K value will be calculated as
K=N/n, where N=Source population and n=final sample size. The starting point (first
participant) will be determined by using the lottery method. Afterward, the required subject will
be included within an interval of K-value until the desired number of participants is obtained.

4.5. Inclusion and Exclusion criteria

4.5.1. Inclusion criteria

➢ All women attending delivery service.
➢ Women who have a gestational age of 20 weeks or more

4.5.2. Exclusion criteria

➢ Women with known hypertension and renal failure
➢ Women who will be critically ill and unable to communicate during the study period.

4.6. Study variables

✓ Age of women
✓ Residence of women
✓ Causes of the problem
✓ Health condition of the women
✓ Gravidity of the mother
✓ Emotional feeling

16
 4.7. Data collection
A structured questionnaire will be designed to assess the magnitude and associated factors of
preeclampsia among women attending delivery services. Data will be collected via face-to-face
interviews using a structured, and pre-tested questionnaire.

4.8. Data quality Control

To assure the quality of data the following measures will be undertaken; a well-designed
questionnaire in English version will be prepared first and then converted to local languages
(Afaan Oromo and Amharic), and backward translation will be carried out to ensure semantic
consistency. Then the instrument will be pre-tested before the study period on 10% of the total
participant (22 women), and amendments will be made accordingly after pre-testing.

4.9. Data processing and analysis

Immediately after the data collection is completed, the completeness and consistency of data
will be cross-checked, and cleaned to ensure accuracy, consistency, and completeness before
entering to computer statistics program. After that, the data will be categorized and analyzed
by using SPSS. Finally, it will be presented in tables and figures.

4.10. Operational definition

✓ Gestational age: is calculated from the last normal menstrual period (LNMP) and
for those women who didn’t recall their last menstrual period, fundal height and/or
ultrasound result was used
✓ Gravidity: the total number of pregnancies, including abortion, ectopic pregnancy,
and any other pregnancies documented on the chart.
✓ Pre-eclampsia: It denotes women with a blood pressure of ≥ 140mmHg systolic or
≥ 90mmHg diastolic on two separate readings taken at least four to six hours apart
after 20 weeks gestation in an individual with previously normal blood pressure and
proteinuria in pregnancy.
✓ Proteinuria: is assessed using the urine dipstick method. Those women with levels
of + 1 and above are classified as having proteinuria.
✓ Risk factor: Something that increases mothers’ chances of developing pre-
eclampsia.

17
 4.11. Ethical consideration
Initially, ethical approval will be taken from Mettu University Ethical Review Committee and
a formal permission letter will be obtained from the Department of Pharmacy, College of Health
Science, Mattu University. All participants will be adequately pre-informed regarding the aim
and the implication of the study and, will be assured that the given information will be kept
confidential and only be used for research purposes.

4.12. Dissemination of results

Based on the result that will be obtained from the study, it will be submitted in hard copies and
softcopy to the Pharmacy department, College of health science, Mattu University. And also,
the documents will be presented to advisors and evaluators. Finally, results will be presented at
different seminars and sent to a scientific journal for possible publication.

18
 5. Work plan and Budget Plan
5.1. Work Plan
Table 1: Gantt Chart showing the activities that will be performed and the
responsible body with the schedule.
S.N Activities Responsible Time(Jan, 2023- August, 2023 G.C)
Body

June 19- July

Jan 21 to April

18,

August 21,

August 28-
Jan 17, 2023

Jan 20, 2023

May22-June
May17-19,

18, 2023

30, 2023
17, 2023

17, 2023
2023

2023

2023
July
1. Title selection & -----------
Submission
2. Literature
redefining
3. Preparation of -----------
Proposal
4. Ethical clearance -----------
from respective
authorities
5. Pre-test -----------
questionnaire
6. Data Collection -----------
7. Data Cleaning -----------
8. Data processing, -----------
analysis,
and interpreting
9. Submission of the -----------
first Draft to the
Advisor
10. Submission of -----------
final Draft
11. Defense and -----------
Final Report
submission

19
 5.2. Budget Plan
Table 2: List of Budgets That will be required to accomplish the task (Stationary, personal
cost, and another budget)

S.No Items Quantity Unit cost(ETB) Multiple price Sub-

total(birr)
1 Pen 5 2 15x2 30
2 Pencil 3 5 3x5 15
3 Ruler 2 8 2x8 16
4 Sharpner 2 5 2x5 10
5 Marker 3 15 3xx15 45
6 Flip chart 5 5 5x5 25
7 Paper 1 Packet 250 1x250 250s
8 Photocopy 100 2 100x2 200
9 Stapler 1 80 1×80 80
10 Flash 1 300 1×300 300
11 Transportation 10 10 100 100
12 Food and water 15 100 1500 1500
13 Computer 1 20,000 1x20,000 20,000
(Laptop Pc)

Total cost 22,571.00

14. Contingency 2257.10
10% of total

Total 24,828.10

20
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Michigan : Wayne State University School of Medicine;, 2014.

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parturition and preeclampsia in women of African ancestry. s.l. : Am J Obstet Gynecol, 2014.

9. L., Duley. Maternal mortality associated with hypertensive disorders of pregnancy in Africa, Asia,
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15. Ogunbode, O. O., Fawole, A. A., Adeniran, A. S., & Ogunbode, A. M. Sociodemographic and
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17. Belay AS, Wudad T. Prevalence and associated factors of pre-eclampsia among pregnant women
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19. Asseffa, N. A., Bukola, F., & Ambaye, M. Prevalence of pre-eclampsia and associated factors
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20. Machano, M.M., Joho, A.A. Prevalence and risk factors associated with severe pre-eclampsia
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Childbirth, 2019.

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ANNEXES
Section 1: Socio-demographic
1. What is your age? _____
2. What is your highest level of education completed?
A. Illiterate B. Read & Write only C. Primary D. Secondary E. Above
3. What is your occupation?
A. Housewife B. Student C. Government workers D. Merchant E. other
4. Address place of residence
A. Urban B. Rural
5. What is your monthly income? _______
6. How many children do you have?________
Section 2: Pre-eclampsia Status
7. Have you ever been diagnosed with pre-eclampsia during any of your pregnancies?
A. Yes B. No
8. If yes, how many times have you had pre-eclampsia?___________
9. Were you diagnosed with pre-eclampsia during your current pregnancy?
_________________
Section 3: Pre-eclampsia Symptoms
10. Did you experience any of the following symptoms during your pregnancy?
A. High blood pressure B. Swelling in the hands and feet C. Headaches
D. Blurred vision E. Abdominal pain F. Decreased urine output
G. Nausea or vomiting
Section 4: Associated Factors
11. Have you ever had any of the following conditions during your pregnancy?
A. Diabetes B. Chronic hypertension C. Kidney disease
D. Thyroid disease E. Lupus or other autoimmune disease
12. Did you receive any antenatal care during your current pregnancy?
A. Yes B. No
13. How many antenatal care visits did you have during your current pregnancy?_____
14. Did your healthcare provider discuss pre-eclampsia with you during your antenatal care
visits?
A. Yes B. No

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 15. Did you receive any medications or interventions to prevent pre-eclampsia during your
pregnancy?
A. Yes B. No
16. Did you have any complications during your pregnancy or delivery?
A. Yes B. No
17. If yes, what were the complications? _________________________
18. Did you have a normal delivery or a caesarean section?
A. Normal delivery B. Caesarean section
19. Did your healthcare provider discuss postpartum care with you?
A. Yes B. No
20. Did you receive any postpartum care after delivery?
A. Yes B. No
21. How many days after delivery did you receive postpartum care? _____________
22. Did you experience any complications during the postpartum period?
A. Yes B. No
23. If yes, what were the complications?
24. Did you receive any treatment for postpartum complications?
A. Yes B. No
25. Do you have any suggestions for improving maternal and child health services in your
area? A. Yes B. No

Thank you for participating in this survey. Your responses will be kept confidential and will be
used for research purposes only.

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