A qualitative document analysis of policies influencing preeclampsia management by midwives in Ghana

Isabella Garti, Michelle Gray, Angela Bromley, Jing-Yu (Benjamin) Tan

Research output: Contribution to journalReview articlepeer-review

6 Citations (Scopus)
124 Downloads (Pure)


Background: Preeclampsia is a global issue that causes significant morbidity and mortality in low- and middle-income countries (LMICs). The care women with preeclampsia receive in LMICs is below the standard experienced by women in westernised countries due to multiple interacting factors. A review of policy factors influencing the management of preeclampsia in Ghana is needed.

Aim: This study focuses on the midwife’s role and scope of practice concerning preeclampsia management. The study aimed to explore the congruence between Ghanaian preeclampsia guidelines and international best practice recommendations for midwifery practice. The study also aimed to describe how recommendations are incorporated into Ghanaian guidelines.

Method/design: This study was a qualitative document analysis of national and tertiary hospital policies related to midwives’ scope of practice in Ghana. Altheide’s five-step process (sampling, data collection, data coding and organisation, data analysis and report) was used to systematically source and analyse the content of written documents.

Results: The findings illustrated several recommendation shortcomings in Ghanaian documents at the national and tertiary hospital levels. The content of Ghanaian preeclampsia management guidelines was not comprehensive, contained conflicting information, and was not backed by research evidence. The standards of practice for midwives were consistent at both the national and tertiary hospital levels. Midwives had limited roles in detection, management, stabilisation, and referral of women with preeclampsia.

Conclusion: Uniform guidelines incorporating international recommendations are urgently needed to improve multi-professional collaboration, solidify midwives’ roles, and optimise maternal and fetal outcomes.
Original languageEnglish
Pages (from-to)612-618
Number of pages7
JournalWomen and Birth
Issue number6
Early online dateJan 2022
Publication statusPublished - Nov 2022

Bibliographical note

Funding Information:
This study is also part of a doctoral research project. Ethical clearance for the broader project has been granted by Charles Darwin University Human Research Ethics Committee and Korle Bu Teaching Hospital Institutional Review Board and Scientific Committee (CDU-HREC H20118; KBTH-STC/IRB/00013/2021).Funding for this study is by the ?Australian Government Research Training Program Scholarship?.

Publisher Copyright:
© 2022 The Authors

Copyright 2022 Elsevier B.V., All rights reserved.


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