Exploring Indonesian midwive's experience of preeclampsia screening and community health volunteer's role to prevent maternal and fetal complications: A qualitative study at the community level

Background: Preeclampsia is one of the causes of maternal death in Indonesia in recent years. Midwives are the foremost health worker in the community. Preeclampsia screening is an important step to prevent maternal and infant deaths. Aims: This study aimed to investigate the experience of midwives in screening preeclampsia and the possibility of involving community health volunteer's in community-level monitoring. Methods: A descriptive qualitative studywas conducted to determine the midwife's experience of preeclampsia screening at the community level. Data were collected using semi-structured in-depth interviews with midwives and community health volunteers in the public health centers of Kroya and Adipala, Central Java, Indonesia and analyzed using content analysis. Results: There were 3 main themes revealed in this study: 1) lack of guidance of screening and monitoring of preeclampsia in the community, 2) Community Health Volunteers have a role in assisting midwives' duties in the community; and 3) lack of family support for pregnant women. A lack of guidance was stated by all midwives in this study. Furthermore,screening has been done based on "maternal cohort registers" and the Maternal and Child Health (MCH) book. These findings suggest that community health volunteers can be involved in the community monitoring of preeclampsia high-risk pregnancies. Conclusion: The results of the study indicate screening for preeclampsia in Indonesia at the community level is not being done effectively. Community health volunteers have been involved in helping midwives work in the community but there is a lack of family involvement in management in mothers at risk of preeclampsia. © 2020 Elsevier B.V., All rights reserved.