BRIEF REPORT Monitoring Severe Pre-Eclampsia and Eclampsia Treatment in Resource Poor Countries: Skilled Birth Attendant Perception of a New Treatment and Monitoring Chart (LIVKAN Chart) Charles A. Ameh • Christine I. Ekechi • Jamilu Tukur Published online: 8 June 2011 Ó Springer Science+Business Media, LLC 2011 Abstract The lack of easy to use protocols and monitoring charts in the management of pre-eclampsia/eclampsia contribute to substandard care of women in resource poor settings. A treatment monitoring tool (LIVKAN chart) has been developed to improve the quality of care for these women. Based on feedback from skilled birth attendants (SBAs), a two page document which provides a visual record of the treatment and monitoring of women with severe pre-eclampsia/eclampsia over a 24 h period was developed. It also contains detailed treatment guidelines as well as a summary of the woman’s treatment. A two page document on instructions for use of the chart was also developed. The chart design was evaluated by different level SBAs via a semi structured questionnaire. There was a 92% (109) response rate. About 30% (33) and 58% (63) of the respondents provided care to women in Primary Health Care and referral health care facilities respectively. Ninety eight percentage of respondents indicated that the chart would be of additional benefit in their care of women with pre-eclamptic/eclampsia. Seventy three percentage of respondents indicated that the chart would also be useful to lower health care facility SBAs. The design of the chart ensures that guidelines for managing/monitoring of patients are instantly available on a concise easy-to-use chart which confers added advantage over other chart designs. Having been evaluated by SBAs, acceptability and utilization in poor resource settings should be high. A study has been designed to evaluate the acceptability and effec- tiveness of this new monitoring chart in both BEOCs and CEOCs in two sub-Saharan African countries. Keywords Maternal mortality and morbidity Á Resource poor countries Á Severe pre-eclampsia/eclampsia Á Monitoring treatment chart Á Standard care Introduction As we approach ever closer to 2015, there has been much attention on the progress made towards achieving the Millenium Development Goals (MGDs) set out in the year 2000. In particular, the progress towards achieving MDG 5, which aims to reduce maternal mortality by two thirds, has been reported to be slower than expected especially in sub- Saharan Africa and South Asia [1, 2]. Deaths from hypertensive disorders in pregnancy account for 10–15% of global direct maternal deaths (50,000 maternal deaths annually) [3–5]. Many of these deaths occur in developing countries where the prevalence of pre-eclampsia is 2.3% of all pregnancies [3, 5–10]. Most of the deaths occur in primary health care settings which lack essential resources, are likely to be staffed by non skilled birth attendants (SBA), are understaffed with SBAs and have limited or no access to specialist care [1]. There is an increased risk of substandard care in such settings and to improve the chances of a good clinical outcome, patients must be stabilised in terms of blood C. A. Ameh (&) Maternal and Newborn Health Unit, Liverpool School of Tropical Medicine, University of Liverpool, Liverpool L3 5QA, UK e-mail: caameh@liverpool.ac.uk C. I. Ekechi Northwest London Hospitals NHS Trust, London, UK e-mail: cekechi@doctors.org.uk J. Tukur Department of Obstetrics and Gynaecology, Bayero University and Aminu Kano University Teaching Hospital, Kano, Nigeria e-mail: jtukur@yahoo.com 123 Matern Child Health J (2012) 16:941–946 DOI 10.1007/s10995-011-0832-7