Critical barriers for preeclampsia diagnosis and treatment in low-resource settings: An example from Bolivia

Lilian Toledo-Jaldin, Sheana Bull, Stephen Contag, Carlos Escudero, Patricio Gutierrez, Alexandra Heath, James M. Roberts, Jean Scandlyn, Colleen G. Julian, Lorna G. Moore

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations


The goals of the United Nation's Millennium Summit for reducing maternal mortality have proven difficult to achieve. In Bolivia, where maternal mortality is twice the South American average, improving the diagnosis, treatment and ultimately prevention of preeclampsia is key for achieving targeted reductions. We held a workshop in La Paz, Bolivia to review recent revisions in the diagnosis and treatment of preeclampsia, barriers for their implementation, and means for overcoming them. While physicians are generally aware of current recommendations, substantial barriers exist for their implementation due to geographic factors increasing disease prevalence and limiting health-care access, cultural and economic factors affecting the care provided, and infrastructure deficits impeding diagnosis and treatment. Means for overcoming such barriers include changes in the culture of health care, use of standardized diagnostic protocols, the adoption of low-cost technologies for improving the diagnosis and referral of preeclamptic cases to specialized treatment centers, training programs to foster multidisciplinary team approaches, and efforts to enhance local research capacity. While challenging, the synergistic nature of current barriers for preeclampsia diagnosis and treatment also affords opportunities for making far-reaching improvements in maternal, infant and lifelong health.

Original languageEnglish (US)
Pages (from-to)139-144
Number of pages6
JournalPregnancy Hypertension
StatePublished - Apr 2019

Bibliographical note

Funding Information:
CGJ and LGM wrote the research grant that supported the workshop with the assistance of JMR, JS and SB. LGM, CGJ, LTJ, AH, SB, SC, CE, JM, and JS planned the workshop. LTJ, SC, CE, PG, and AH provided information about the operation of the Bolivian health care system. LGM prepared the initial draft of the manuscript using an outline generated by all the authors. All authors reviewed, contributed to, and approved the final version for publication.

Publisher Copyright:
© 2019 International Society for the Study of Hypertension in Pregnancy


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