Preventing a Leading Killer: A Look at PE/E

Home Maya Ale was living in a scenic village on the banks of the Seti River in central Nepal, about 20 miles from the city of Pokhara and the nearest hospital. Like many women in rural Nepal, she had limited access to health care. While pregnant with her second child, Home Maya suffered a seizure—a telltale sign of eclampsia.
 
Alarmed by her condition, Mrs. Ale’s husband brought her to the nearest health clinic, where staff referred her to the hospital in Pokhara. When the family arrived at the Western Regional Hospital, Mrs. Ale was semiconscious and in serious condition. Fortunately for this 25-year-old mother, she was in a hospital where staff had been trained to diagnose, treat and monitor this life-threatening complication.
 
Mrs. Ale survived this obstetric emergency with treatment and delivered a healthy baby boy. Other young women and mothers haven’t been as lucky. Pre-eclampsia/eclampsia is now the second leading cause of maternal death in Nepal, with recent evidence showing that PE/E accounts for 21% of all maternal deaths.
 
WHO has identified calcium as one of the most effective and low-cost interventions among pregnant women for prevention of PE/E in a calcium-deficient setting such as Nepal. MCHIP partnered with the USAID-funded bilateral Nepal Family Health Program II (NFHP II) under the leadership of the Family Health Division (FHD) of the Ministry of Health and Population (MOHP) to test the acceptability of calcium in two forms (tablets and powder) among pregnant women. This study was conducted for three months in two village development committees (VDCs) of Banke district in southwestern Nepal.

Results show that, when they are properly educated about it, women prefer calcium tablets over powder and that on average 98% would like to take calcium in the future. These findings will be used to design a national pilot study. 
 
For Sakila Ansari this is welcome news. As a female community health worker volunteer, she has been given the responsibility from her local health post to distribute calcium to pregnant women. During her efforts, she met a 16-year-old Muslim girl, Mallika Sahajada, who is pregnant for the first time and in her second trimester. Mallika had tried taking the calcium tablets for a few days and then abruptly stopped. Sakila counseled her on the importance of taking calcium, especially for a pregnancy at a young age, such as hers. After hearing the other women’s experiences of taking calcium and learning the benefits, she agreed it was best for her and her unborn child.
 
Thanks to the work of Sakila, Mallika will have one more chance of surviving. Home Maya knows just how precious that can be.