Poster Session 4
Category: Public Health/Global Health
Poster Session 4
Laura Crook, MA (she/her/hers)
Medical Student
Washington University in St. Louis School of Medicine
St Louis, Missouri, United States
Kabiru Umar Ibrahim, MBBS
Department of Medicine, Aminu Kano Teaching Hospital
Kano, Kano, Nigeria
Nura Abdulkarim, MBBS
Murtala Muhammad Specialist Hospital
Kano, Kano, Nigeria
Chukwuebuka F. Okoye, MBBS
Cardiovascular Research Unit, University of Abuja and University of Abuja Teaching Hospital
Gwagwalada, Abuja, Federal Capital Territory, Nigeria
Adaego Orji, MBBS, MPH
Cardiovascular Research Unit, University of Abuja and University of Abuja Teaching Hospital
Gwagwalada, Abuja, Federal Capital Territory, Nigeria
Cecilia Nartey, MD, MPH
Department of Medicine, Cardiovascular Division and Global Health Center, Washington University in St. Louis
St. Louis, Missouri, United States
Kamilu Karaye, MBBS, PhD
Department of Medicine, Aminu Kano Teaching Hospital
Kano, Kano, Nigeria
Kathryn J. Lindley, MD (she/her/hers)
Associate Professor
Department of Medicine, Division of Cardiology, Vanderbilt University Medical Center
Nashville, Tennessee, United States
Victor Davila-Roman, MD
Department of Medicine, Cardiovascular Division and Global Health Center, Washington University in St. Louis
St. Louis, Missouri, United States
Dike Ojji, MBBS, PhD
Cardiovascular Research Unit, University of Abuja and University of Abuja Teaching Hospital
Gwagwalada, Abuja, Federal Capital Territory, Nigeria
Mark Huffman, MD, MPH
Department of Medicine, Cardiovascular Division and Global Health Center, Washington University in St. Louis
St. Louis, Missouri, United States
Zainab Mahmoud, MD, MSc
Department of Medicine, Cardiovascular Division and Global Health Center, Washington University in St. Louis
St. Louis, Missouri, United States
Nigeria has one of the highest rates of maternal morbidity and mortality globally, with hypertensive disorders of pregnancy (HDP), including preeclampsia, causing one-third of all maternal deaths. While aspirin prophylaxis is an effective intervention for preventing preeclampsia and its subsequent morbidity and mortality, aspirin utilization in Nigeria remains unclear. This study aims to identify the key facilitators and barriers to aspirin implementation, providing insights to inform strategies to enhance its adoption.
Study Design:
Between August 2024 and November 2024, 18 in-depth interviews and 8 focus group discussions were conducted with healthcare workers (obstetricians, cardiologists, nurses), patients, and administrators across four tertiary hospitals in Nigeria. Data were collected in English and Hausa, transcribed, translated, and analyzed using Dedoose software. Using the updated Consolidated Framework for Implementation Research, qualitative data were analyzed for barriers and facilitators to aspirin implementation across five domains: individual, inner setting, outer setting, innovation, and implementation process.
Results:
Identified facilitators to implementation included the multidisciplinary expertise available at these tertiary centers, motivation for change driven by the recognized severity of HDP, high capacity for research, and alignment with current practices. Barriers included limited awareness among both patients and providers, overburdened healthcare systems and providers, and financial constraints at the individual level. Implementation strategies highlighted education/training for both patients and providers, media campaigns to promote the importance of early antenatal care, increasing the accessibility of aspirin and development of nationwide guidelines around aspirin prophylaxis.
Conclusion:
This study identified facilitators and barriers to the implementation of aspirin prophylaxis against preeclampsia and proposed implementation strategies to increase aspirin use among pregnant patients at risk of developing HDP.