National Capacity of Healthcare Facilities for Screening and Management of Hypertensive Disorders of Pregnancy: A secondary Analysis of 2021 Nepal Health facility survey
1
Emory University, Atlanta, United States
2
Herd International, Lalitpur, Nepal
3
Indiana University, Bloomington, United States
Popul. Med. 2026;8(Supplement Supplement 1):A2350
ABSTRACT
BACKGROUND:
Hypertensive disorders in pregnancy (HDP) are the second most common cause of maternal mortality in Nepal accounts for approximately 12% of maternal deaths. Quality services, which depend on the readiness of health facilities for screening, management, and referral, are crucial to improving maternal health outcomes. In this study, we aimed to assess the structural readiness of healthcare facilities in Nepal for screening and managing HDP and further determine their association with geographic and system-level factors.
METHODS:
We conducted a cross-sectional study using data from a nationally representative survey, which employed a two-stage stratified sampling technique. We applied the Donabedian framework and WHO Service Availability and Readiness Assessment manual to guide our study. We performed a weighted descriptive analysis and calculated average readiness scores for HDP screening and management. Facility-, provinceand district-level maps were plotted to visualize nationwide variation in readiness scores. We conducted asurvey weighted multivariable linear regression analysis to determine HDP readiness scores with healthcarefacilities, location, ecological region, provinces, managing authority, and quality assurance.
RESULTS:
Among 802 facilities offering maternal health services, most were health posts (75%), followed by hospitals (12.4%), primary health care centers (6.2%), and basic health units (5.5%). Availability of indicators to screen and manage HDP varied substantially: blood pressure measuring devices were nearly universally available, while antihypertensive injections (5.2%) were least available. Mapping revealed variation across districts, and facility types in readiness scores for screening and managing HDP. Regression analysis showed significantly lower readiness scores in health posts (β=-7.5, 95% CI: -10.8, -4.2, p<0.001) compared to hospitals. Facilities performing regular quality assurance activities had higher management readiness scores (β=5.0, 95% CI: 1.4, 8.5, p=0.006) compared to those that did not perform.
CONCLUSIONS:
Structure readiness to screen and manage HDP was low and unevenly distributed across facility types, districts, and provinces.
Hypertensive disorders in pregnancy (HDP) are the second most common cause of maternal mortality in Nepal accounts for approximately 12% of maternal deaths. Quality services, which depend on the readiness of health facilities for screening, management, and referral, are crucial to improving maternal health outcomes. In this study, we aimed to assess the structural readiness of healthcare facilities in Nepal for screening and managing HDP and further determine their association with geographic and system-level factors.
METHODS:
We conducted a cross-sectional study using data from a nationally representative survey, which employed a two-stage stratified sampling technique. We applied the Donabedian framework and WHO Service Availability and Readiness Assessment manual to guide our study. We performed a weighted descriptive analysis and calculated average readiness scores for HDP screening and management. Facility-, provinceand district-level maps were plotted to visualize nationwide variation in readiness scores. We conducted asurvey weighted multivariable linear regression analysis to determine HDP readiness scores with healthcarefacilities, location, ecological region, provinces, managing authority, and quality assurance.
RESULTS:
Among 802 facilities offering maternal health services, most were health posts (75%), followed by hospitals (12.4%), primary health care centers (6.2%), and basic health units (5.5%). Availability of indicators to screen and manage HDP varied substantially: blood pressure measuring devices were nearly universally available, while antihypertensive injections (5.2%) were least available. Mapping revealed variation across districts, and facility types in readiness scores for screening and managing HDP. Regression analysis showed significantly lower readiness scores in health posts (β=-7.5, 95% CI: -10.8, -4.2, p<0.001) compared to hospitals. Facilities performing regular quality assurance activities had higher management readiness scores (β=5.0, 95% CI: 1.4, 8.5, p=0.006) compared to those that did not perform.
CONCLUSIONS:
Structure readiness to screen and manage HDP was low and unevenly distributed across facility types, districts, and provinces.
| eISSN: | 2654-1459 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
