Measuring Regional and District Variations in the Incidence of Pregnancy-induced Hypertension (PIH) in Ghana: Challenges, Opportunities and Implications for Maternal and Newborn Health Policy and Programs

Abstract

OBJECTIVES: The objectives were to assess the quality of health management information system (HMIS) data needed for assessment of local area variation in pregnancy induced hypertension (PIH) incidence and to describe district and regional variations in PIH incidence. METHODS: A retrospective review of antenatal and delivery records of 2,682 pregnant women in ten district hospitals in the Greater Accra and Upper West regions of Ghana was conducted in 2013. Quality of HMIS data was assessed by completeness of reporting. The incidence of PIH was estimated for each district. RESULTS: Key variables for routine assessment of PIH such as blood pressure at antenatal visits, weight and height were 95% to 100% complete. Fundal height, gestational age and blood pressure at delivery were not consistently reported. The incidence of PIH differed significantly between Greater Accra region (6.1%) and Upper West region (3.2%). Prevalence of obesity among pregnant women in Greater Accra region (13.9%) was significantly higher than that of women in Upper West region (2.2%). CONCLUSIONS: More attention needs to be given to understanding local area variations in PIH and possible relationships with urbanization and lifestyle changes that promote obesity, to inform maternal and newborn health policy. This can be done with good quality routine HMIS data. This article is protected by copyright. All rights reserved.