Evaluation of Midwifery Competence in Managing Severe Preeclampsia in Rural Primary Health Centers

African Journal of Nursing and Midwifery | Vol. 14, No. 8, August 2026 | pp. 50–59

DOI: 10.46882/2026/AJNM/000138

Original Research Article

Title: Evaluation of Midwifery Competence in Managing Severe Preeclampsia in Rural Primary Health Centers

Names of Authors: Oluwaseun A. Adebayo¹, Comfort N. Okafor²

Authors’ Affiliations:
¹Department of Nursing Science, Obafemi Awolowo University, Ile-Ife, Nigeria
²School of Midwifery, University Teaching Hospital, Enugu, Nigeria

Abstract:
Hypertensive disorders of pregnancy remain a primary contributor to avoidable maternal mortality across rural clinical settings. This descriptive cross-sectional study evaluated clinical knowledge and active management competencies for severe preeclampsia among midwives practicing within rural primary health centers. A sample of 140 registered midwives completed a pre-validated clinical scenario survey, complemented by objective checklist audits during simulated emergencies. Data analysis relied on descriptive statistics and multivariable logistic regression models. The results showed that while 82.1% of the midwives correctly identified magnesium sulfate as the first-line anticonvulsant, only 38.6% demonstrated appropriate execution of the intramuscular loading dose regimen under simulation criteria. Critical errors were linked to missing clinical indicators for toxicity monitoring, such as patellar reflex checks and hourly urine output assessments. Systemic supply barriers were common, with 64.3% of clinics experiencing magnesium sulfate stockouts within the past quarter. Midwives with specific emergency obstetric training inside the last 12 months were significantly more likely to achieve optimal competence ratings (AOR = 3.12, 95% CI: 1.64–5.94, p = 0.002). The study concludes that dangerous implementation gaps persist due to poor access to emergency updates and essential drug supplies. Mitigating rural maternal mortality requires regular simulation-based training alongside reliable obstetric pharmaceutical logistics.

Keywords: Severe Preeclampsia; Midwifery Competence; Magnesium Sulfate; Rural Health; Maternal Mortality; Simulation Training.

Manuscript Timeline: Received May 14, 2026; Revised July 03, 2026; Accepted July 18, 2026; Published August 12, 2026.

Citation: Adebayo, O. A., & Okafor, C. N. (2026). Evaluation of Midwifery Competence in Managing Severe Preeclampsia in Rural Primary Health Centers. African Journal of Nursing and Midwifery, 14(8), 50–59.

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