‘A novel approach to expedite evidence to impact in Pre-eclampsia: co-developed Policy Labs in Zambia and Sierra Leone.’

Abstract

Background Pre-eclampsia (PE) is a leading causes of maternal and neonatal mortality; 30,000 PE-related maternal deaths occur annually, with 70% in Sub-Saharan Africa (SSA) and 16% in South Asia. We have shown that early, accurate detection of hypertension combined with planned early delivery in women with suspected pre-eclampsia between 34 and 37 weeks of gestation significantly reduces stillbirth and severe maternal hypertension. There is an urgent need for this novel evidence to be included clinical management of women and babies suffering the worst outcomes. This article describes co-development and delivery of Policy Labs in Sierra Leone and Zambia as part of a strategy to expedite integration of new knowledge into Pre-eclampsia care pathways. Methods Working with King’s Policy Institute, we co-developed and delivered two Policy Labs based on their 8-step process and the ‘trust-translation-timing’ model. Policy Labs were undertaken in Freetown, Sierra Leone and Lusaka, Zambia. Participants were purposively selected in each setting to represent a diverse range of relevant stakeholders. Main outcome measures included Policy Lab attendance; Policy Lab delivery; Policy Lab report and agreed outputs. Results Two Policy Labs were held: in Zambia (14th February 2023) and Sierra Leone (7th March 2023), attended by 35 and 39 diverse stakeholders respectively, included women via pre-recorded video clips. Both labs were successfully facilitated by local, well-respected female team members, and addressed co-developed questions (‘What are enablers and barriers to offering planned early delivery between 34 and 37 weeks?’ – Zambia; ‘How can we improve timely detection and appropriate action in women with Pre-eclampsia?’ – Sierra Leone) in answer to context-specific emerging evidence. Participants at both labs identified lack of Pre-eclampsia awareness as a key barrier, and recommended development of locally designed, community based strategies to increase access to timely, evidence-based Pre-eclampsia management. Conclusions Policy Labs are a novel approach to facilitate transfer of new knowledge into policy and action. Future Policy Labs should feature the women, participating in real time, at the forefront of the discussion.