RESUMEN
A prospective, quasi-experimental study was carried out in 2009 at urban health centres (UHCs)of five townships of Mandalay, Myanmar, to improve the skill of midwives (MWs) in diagnosis andreferral of pre-eclampsia (PE) from UHC to the Central Women’s Hospital (CWH) and to enhancethe supervision of midwives by lady health visitors (LHVs). The intervention was training on qualityantenatal care focusing on PE using an updated training manual. Altogether, 75 health care providers(MWs & LHVs) participated. In this study, data were extracted from patient registers and monthlyreports of UHCs and CWH. Interviewers were trained regarding the conduct of semi-structuredquestionnaires to elicit knowledge and to use checklists in observation of skills in screening ofPE, measuring blood pressure and urine protein (dipstick test). A guide for LHVs was also usedto obtain data, and data was collected six months prior to and after the intervention. Significantimprovements from baseline to endline survey occurred in the knowledge (p<0.001) and skill levels(p<0.001) including skills for screening, measuring blood pressure and urine protein. At CWH, therewas an increase in referred cases of PE after the intervention, from 1.25% to 2.56% (p<0.001). Inconclusion, this study highlights the early detection of pre-eclampsia by widespread use of qualityantenatal care, education and training of health-care providers to improve their performance andincrease human resources for health care, in order to enable women in our society to have healthypregnancies and healthy babies.