A cross-sectional study of healthcare provider perceptions of the management of epilepsy in pregnancy in sub-Saharan Africa.

Background: Epilepsy prevalence in sub-Saharan Africa is high with a significant treatment gap. In this context, epilepsy presents substantial challenges to effective and safe reproductive and maternal healthcare. To improve this, it is important to understand the views and perceptions of healthcare professionals delivering epilepsy care to this population.

Methods: This study uses an online questionnaire which asked healthcare professionals (both from nursing and medical backgrounds) who work in sub-Saharan African countries to rate a set of pre-established options designed with the feedback of a local focus group of epilepsy experts from countries targeted. The questionnaire consisted of 21 questions and was a mix of multiple choice and Likert scale questions on managing reproductive health in women in local settings.

Results: Of 203 healthcare professionals respondents from over 10 countries majority were doctors (48%) or nurses (36%). The Gambia (28.6%), Nigeria (22.2%), Cameroon (13.3%) and Zambia (9.4%) accounted for nearly three-quarters of respondents. Over half (54%) felt that they have the necessary training to counsel women with epilepsy on reproductive health and pregnancy. Only 40% reported they regularly discuss family planning. Carbamazepine was reported to be the most used anti-seizure medication (ASM) for childbearing age women. Key challenges outlined were epilepsy awareness among patients and their families, information deficit on ASMs and pregnancy and access to a sufficient range of ASMs.

Conclusion: Understanding the challenges faced by health professionals in sub-Sharan Africa, provides better comprehension of the specific "treatment-education gap" in counselling women with epilepsy on ASM risks and benefits.