Influences on participant reporting in the World Health Organisation drugs exposure pregnancy registry; a qualitative study

BMC Health Services Research

Lynn M Atuyambe²  Ushma Mehta⁸  Edwin Were^1,10  Anthony Mbonye⁴  Josaphat Byamugisha³  Christine Clerk⁹  Omar Egesah¹  Lucy Yevoo⁵  Melba Gomes⁶  Elizabeth N Allen⁷ 

[1]Department of Anthropology, Moi University, Eldoret, Kenya

[2]Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda

[3]Department of Obstetrics and Gynaecology, Makerere University, Kampala, Uganda

[4]Ministry of Health, Kampala, Uganda

[5]Dodowa Health Research Centre, Dodowa, Ghana

[6]World Health Organisation, 1211 Avenue Appia, Geneva 27, Switzerland

[7]Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa

[8]Independent Pharmacovigilance Consultant, Cape Town, South Africa

[9]School of Public Health, University of Ghana, Dodowa, Ghana

[10]Department of Reproductive Health, Moi University, Eldoret, Kenya

关键词: Medicine use;    Alcohol;    Qualitative;    Validity;    Uganda;    Kenya;    Ghana;    Drug safety;    Registry;    Pregnancy;   

Others  :  1092510
DOI  :  10.1186/s12913-014-0525-1

 received in 2014-01-08, accepted in 2014-10-13,  发布年份 2014

【 摘 要 】

Background

The World Health Organisation has designed a pregnancy registry to investigate the effect of maternal drug use on pregnancy outcomes in resource-limited settings. In this sentinel surveillance system, detailed health and drug use data are prospectively collected from the first antenatal clinic visit until delivery. Over and above other clinical records, the registry relies on accurate participant reports about the drugs they use. Qualitative methods were incorporated into a pilot registry study during 2010 and 2011 to examine barriers to women reporting these drugs and other exposures at antenatal clinics, and how they might be overcome.

Methods

Twenty-seven focus group discussions were conducted in Ghana, Kenya and Uganda with a total of 208 women either enrolled in the registry or from its source communities. A question guide was designed to uncover the types of exposure data under- or inaccurately reported at antenatal clinics, the underlying reasons, and how women prefer to be asked questions. Transcripts were analysed thematically.

Results

Women said it was important for them to report everything they had used during pregnancy. However, they expressed reservations about revealing their consumption of traditional, over-the-counter medicines and alcohol to antenatal staff because of anticipated negative reactions. Some enrolled participants' improved relationship with registry staff facilitated information sharing and the registry tools helped overcome problems with recall and naming of medicines. Decisions about where women sought care, which influenced medicines used and antenatal clinic attendance, were influenced by pressure within and outside of the formal healthcare system to conform to conflicting behaviours. Conversations also reflected women's responsibilities for producing a healthy baby.

Conclusions

Women in this study commonly take traditional medicines in pregnancy, and to a lesser extent over-the-counter medicines and alcohol. The World Health Organisation pregnancy registry shows potential to enhance their reporting of these substances at the antenatal clinic. However, more work is needed to find optimal techniques for eliciting accurate reports, especially where the detail of constituents may never be known. It will also be important to find ways of sustaining such drug exposure surveillance systems in busy antenatal clinics.

【 授权许可】

   
2014 Allen et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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