Hypertensive Disorders in Pregnancy: Screening and Management Capacity in Primary Health Centres Across Adamawa State

Hypertensive disorders in pregnancy (HDP), encompassing gestational hypertension, preeclampsia, and eclampsia, are the leading cause of maternal death in Nigeria, and their timely identification at primary healthcare level is essential to preventing severe maternal outcomes. This study evaluates HDP screening and management capacity at primary health centres in Adamawa State, North East Nigeria. Twenty PHCs in Yola North, Numan, and Mubi North LGAs were assessed using a structured capacity assessment tool. Indicators included blood pressure equipment availability and calibration, urine dipstick availability, health worker training on HDP recognition, magnesium sulphate stocking, and emergency referral systems. Exit interviews with 100 antenatal attendees assessed blood pressure measurement and HDP counselling receipt. Blood pressure was measured at all 20 PHCs, but sphygmomanometers were calibrated or functional only in 65 percent. Urine dipstick for proteinuria was available in 55 percent. Health workers trained in HDP recognition within the preceding two years constituted only 38 percent of assessed staff. Magnesium sulphate was stocked in only 30 percent of PHCs. The study reveals major HDP screening and emergency management gaps at Adamawa State PHC level. Recommendations include sphygmomanometer maintenance contracts, magnesium sulphate integration into PHC medicine lists, and biennial HDP identification and management training for all PHC staff. Keywords: hypertensive disorders in pregnancy, primary health centre, Adamawa State, screening capacity, preeclampsia