Implementing components of the PHC for PE/E model in Nigeria: A cost analysis

The maternal mortality rate in Nigeria is 814 per 100,000 live births [1]. Pre-eclampsia and eclampsia (PE/E) is the 4th leading cause of maternal mortality in Nigeria, accounting for 11% of maternal deaths [2]. PE is identified by high blood pressure and protein in urine within pregnant women after 20 weeks of gestation. Women with PE are at increased risk for organ damage/failure, pre-term birth, loss of pregnancy, and stroke. PE can progress to eclampsia, which is characterized by seizures, and may be associated with kidney and liver damage, as well as maternal death. Infant risks include pre-term birth, low birth weight, stillbirth and death, among others [3]. Infants born preterm due to PE are at higher risk of long term health issues. The risks of PE/E can be mitigated with regular screening during antenatal care (ANC) as well as the postnatal period. Once detected, regular monitoring of PE can lessen progression to severe PE/E, and even severe PE/E can be managed through administration of magnesium sulfate (MgSO4) and antihypertensive drugs [3].