Presentation at the Global Maternal Newborn Health Conference, October 20, 2015
Background: Despite the evidence that magnesium sulfate ( MgSO4) is the drug of choice for managing severe pre-eclampsia and eclampsia (SPE/E), its usage seems low in limited resources settings for various reasons including the unjustified fear of serious side effects. Most Health information management systems do not report the usage of MgSo4 for SPE/E. Thus, a new methodology was designed to estimate national coverage of life saving commodities including magnesium sulfate.
Methods: The estimation methodology consisted of convening a group of national technical experts and using the Delphi method to come to consensus on key data elements that were applied to a simple algorithm, generating a non-precise national estimate of coverage of magnesium sulfate. To calculate the coverage the following data were used: distribution of births by location and estimates of magnesium sulfate usage in each of those settings, provider performance, and adjustments for stock in rates and proper diagnosis of SPE/E. This exercise was conducted in 2014 in Liberia.
Results: In Liberia the majority (85%) of SPE/E cases occur in a health facility with 62% in public health facilities. Providers’ performance was 48.98% and stock out rate was 52.3 in public facilities. Proper diagnosis of SPE/E was believed to be made in 42.8% of cases in public facilities and 14.1 % in private facilities. Coverage of magnesium sulfate for SPE/E was 43% in Liberia.
Conclusion: The new methodology for estimating coverage of magnesium sulfate for SPE/E was found to be feasible by facilitators of the exercise. Despite the imprecision of the estimates, experts agreed it provides data that could be used to improve coverage of magnesium sulfate through better reporting at facility level.