{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T10:11:22Z","timestamp":1789035082259,"version":"build-2803163510"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Reprod. Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Preeclampsia and eclampsia are major causes of maternal and perinatal morbidity and mortality in low- and middle-income countries. Magnesium sulfate (MgSO\u2084) is the most effective intervention for eclampsia prevention and treatment. However, evidence for its use at the primary healthcare level remains limited as most studies have focused on hospital settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Electronic databases were comprehensively searched for relevant studies published between January 2003 and December 2024. MEDLINE via PubMed, Cochrane Library, African Index Medicus, and Google Scholar were comprehensively searched for relevant studies. Studies reporting the use of MgSO\u2084 in primary healthcare settings were included. Data were extracted using a standardized data collection form.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seven studies, most of which were conducted in Nigeria, met the inclusion criteria. MgSO\u2084 was available in most primary healthcare facilities but remained underutilized. Task sharing with community health workers was identified as a promising strategy for improving its use. Also, shortcomings were observed in the referral and evacuation system as well as in patient monitoring mechanisms. All studies highlighted the need to strengthen the continuous and regular training and supervision of CHWs to improve early detection and appropriate management of preeclampsia cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MgSO\u2084 administration at the primary healthcare level is a critical intervention for reducing maternal and perinatal mortality associated with preeclampsia and eclampsia. Strengthening task-sharing approaches and community-level integration may enhance health system resilience in sub-Saharan Africa.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/frph.2026.1911083","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T09:40:31Z","timestamp":1789033231000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Magnesium sulfate for severe preeclampsia and eclampsia management at the primary healthcare level in sub-Saharan Africa: a systematic review"],"prefix":"10.3389","volume":"8","author":[{"given":"Assitan Baya","family":"Sidibe","sequence":"first","affiliation":[{"name":"National Office for Reproductive Health (ONASR)","place":["Bamako, Mali"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Delamou","sequence":"additional","affiliation":[{"name":"African Center of Excellence for Prevention and Control of Communicable Diseases","place":["Conakry, Guinea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatoumata Bintou","family":"Traore","sequence":"additional","affiliation":[{"name":"National Institute of Public Health (INSP)","place":["Bamako, Mali"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youssouf","family":"Keita","sequence":"additional","affiliation":[{"name":"Global Financing Facility, World Bank Bamako","place":["Bamako, Mali"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben Moulaye","family":"Idriss","sequence":"additional","affiliation":[{"name":"National Office for Reproductive Health (ONASR)","place":["Bamako, Mali"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aminata","family":"Ciss\u00e9","sequence":"additional","affiliation":[{"name":"National Office for Reproductive Health (ONASR)","place":["Bamako, Mali"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"04147","DOI":"10.7189\/jogh.16.04147","article-title":"Global burden of maternal disorders, 1990\u20132021: insights from the global burden of disease study 2021 and challenges for achieving 2030 sustainable development goals","volume":"16","author":"Zhu","year":"2026","journal-title":"J Glob Health"},{"key":"B2","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1053\/j.semperi.2009.02.010","article-title":"The global impact of Pre-eclampsia and eclampsia","volume":"33","author":"Duley","year":"2009","journal-title":"Semin Perinatol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"699","DOI":"10.2471\/BLT.05.027300","article-title":"Causes of stillbirths and early neonatal deaths: data from 7993 pregnancies in six developing countries","volume":"84","author":"Nguyen Ngoc","year":"2006","journal-title":"Bull World Health Organ"},{"key":"B4","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1016\/j.bpobgyn.2011.04.002","article-title":"Pre-eclampsia in low and middle income countries","volume":"25","author":"Firoz","year":"2011","journal-title":"Best Practice & Research Clinical Obstetrics & Gynaecology"},{"key":"B5","author":"Kinney","year":""},{"key":"B6","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1016\/j.gyobfe.2005.06.025","article-title":"Int\u00e9r\u00eat du sulfate de magn\u00e9sium dans la prise en charge de la pr\u00e9\u00e9clampsie","volume":"34","author":"Rozenberg","year":"2006","journal-title":"Gyn\u00e9cologie Obst\u00e9trique & Fertilit\u00e9"},{"key":"B7","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1097\/01.grf.0000160314.59736.d2","article-title":"Magnesium sulfate prophylaxis in preeclampsia: evidence from randomized trials","volume":"48","author":"Sibai","year":"2005","journal-title":"Clin Obstet Gynecol"},{"key":"B8","author":"Sibai","year":""},{"key":"B9","doi-asserted-by":"publisher","first-page":"926","DOI":"10.1186\/s12913020057951-1","article-title":"Pr\u00e9paration des etablissements de sant\u00e9 et connaissances des prestataires de soins: facteurs corr\u00e9l\u00e9s \u00e0 un diagnostic et une prise en charge ad\u00e9quats de la pr\u00e9\u00e9clampsie \u00e0 Kinshasa, en r\u00e9plublique d\u00e9mocratique du Congo","volume":"20","author":"Nkamba","year":"2020","journal-title":"Health Serv Res"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1883","DOI":"10.1111\/14710528.14400","article-title":"Pratiques cliniques relatives \u00e0 l\u2019utilisation du sulfate de magn\u00e9sium dans le traitement de la pr\u00e9\u00e9clampsie et de l\u2019\u00e9clampsie: une enqu\u00eate multicentrique","volume":"124","author":"Long","year":"2017","journal-title":"BJOG"},{"key":"B11","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1186\/1472696310340","article-title":"Identifier les obstacles \u00e0 la disponibilit\u00e9 et \u00e0 l\u2019utilisation de injection de sulfate de magn\u00e9sium dans les pays \u00e0 faibles ressources: une \u00e9tude de cas en zambie","volume":"10","author":"Ridge","year":"2010","journal-title":"BMC Health Serv Res"},{"key":"B12","doi-asserted-by":"publisher","first-page":"926","DOI":"10.1186\/s12913-020-05795-1","article-title":"Health facility readiness and provider knowledge as correlates of adequate diagnosis and management of pre-eclampsia in Kinshasa, democratic Republic of Congo","volume":"20","author":"Nkamba","year":"","journal-title":"BMC Health Serv Res"},{"key":"B13","doi-asserted-by":"publisher","first-page":"e1001589","DOI":"10.1371\/journal.pmed.1001589","article-title":"A risk prediction model for the assessment and triage of women with hypertensive disorders of pregnancy in low-resourced settings: the miniPIERS (Pre-eclampsia integrated estimate of RiSk) multi-country prospective cohort study","volume":"11","author":"Payne","year":"2014","journal-title":"PLoS Med"},{"key":"B14","first-page":"46","article-title":"Optimisation des r\u00f4les du personnel de sant\u00e9 par la d\u00e9l\u00e9gation des t\u00e2ches pour am\u00e9liorer l\u2019acc\u00e8s aux interventions de sant\u00e9 maternelle et n\u00e9onatale [recommandations]","volume":"20","year":"2013","journal-title":"OMS"},{"key":"B15","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1186\/s12978-020-0897-0","article-title":"A primary health care model for managing pre-eclampsia and eclampsia in low- and middle- income countries","volume":"17","author":"Warren","year":"2020","journal-title":"Reprod Health"},{"key":"B16","doi-asserted-by":"publisher","first-page":"e1000097","DOI":"10.1371\/journal.pmed.1000097","article-title":"The prisma group. preferred reporting items for systematic reviews and meta-analyses: the prisma statement","volume":"6","author":"Moher","year":"2009","journal-title":"PLoS Med"},{"key":"B17","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1016\/j.preghy.2021.05.005","article-title":"The ability and safety of community-based health workers to safely initiate lifesaving therapies for pre-eclampsia in ogun state, Nigeria: an analysis of 260 community treatments with MgSO4 and\/or methyldopa","volume":"25","author":"Adepoju","year":"2021","journal-title":"Pregnancy Hypertens"},{"key":"B18","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1186\/s1288401505548-8","article-title":"Factors influencing the use of magnesium sulfate in the management of preeclampsia\/eclampsia in health facilities in northern Nigeria: a mixed-methods study","volume":"15","author":"Oguntunde","year":"2015","journal-title":"BMC Pregnancy Childbirth"},{"key":"B19","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1186\/s129780160216y","article-title":"Human resource constraints and the prospect of task-sharing among community health workers for the detection of early signs of pre-eclampsia in Ogun State, Nigeria","volume":"13","author":"Adetoro","year":"2016","journal-title":"Reprod Health"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1461","DOI":"10.4236\/health.2013.59199","article-title":"Attrition from care after the critical phase of severe pre-eclampsia and eclampsia: insights from an intervention with magnesium sulphate in a primary care setting in northern Nigeria","volume":"5","author":"Ishaku","year":"2013","journal-title":"Health"},{"key":"B21","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1186\/s1297801602189","article-title":"Et le groupe de travail sur la faisabilit\u00e9 du CLIP Nigeria","volume":"13","author":"Sotunsa","year":"2016","journal-title":"Reprod Health"},{"key":"B22","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1186\/s12978-016-0220-2","article-title":"Community health worker knowledge and management of pre-eclampsia in southern Mozambique","volume":"13","author":"Boene","year":"2016","journal-title":"Reprod Health"},{"key":"B23","doi-asserted-by":"publisher","first-page":"346","DOI":"10.1186\/s1288401819721-1","article-title":"Screening and management of preeclampsia and eclampsia in prenatal, labor and delivery services: results of cross-sectional observational studies conducted in six sub-saharan African countries","volume":"18","author":"Rawlins","year":"2018","journal-title":"BMC Pregnancy Childbirth"},{"key":"B24","first-page":"38","volume-title":"Recommendations de l\u2019OMS Pour la Pr\u00e9vention et le Traitement de la Pr\u00e9\u00e9clampsie et de L\u2019\u00e9clampsie","year":"2014"},{"key":"B25","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1186\/s12978-016-0220-2","article-title":"Community health worker knowledge and management of pre-eclampsia in southern Mozambique","volume":"13","author":"Boene","year":"2016","journal-title":"Reprod Health"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12884-015-0554-8","article-title":"Factors influencing the use of magnesium sulphate in pre-eclampsia\/eclampsia management in health facilities in northern Nigeria: a mixed methods study","volume":"15","author":"Oguntunde","year":"2015","journal-title":"BMC Pregnancy Childbirth"},{"key":"B27","doi-asserted-by":"publisher","first-page":"457","DOI":"10.9745\/GHSP-D-19-00124","article-title":"Prise en charge de la pr\u00e9\u00e9clampsie, de la pr\u00e9\u00e9clampsie s\u00e9v\u00e8re et de l\u2019\u00e9clampsie dans les \u00e9tablissements de soins primaires au Bangladesh","volume":"7","author":"Williams","year":"2019","journal-title":"Glob Health Sci Pract"},{"key":"B28","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1186\/s12978-016-0219-8","article-title":"Community health worker knowledge and management of pre-eclampsia in rural Karnataka state, India","volume":"13","author":"Ramadurg","year":"2016","journal-title":"Reprod Health"},{"key":"B29","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1186\/s12978-016-0215-z","article-title":"Health care provider knowledge and routine management of pre-eclampsia in Pakistan","volume":"13","author":"Sheikh","year":"2016","journal-title":"Reprod Health"},{"key":"B30","doi-asserted-by":"publisher","first-page":"457","DOI":"10.9745\/GHSP-D-19-00124","article-title":"Management of preeclampsia, severe preeclampsia, and eclampsia at primary care facilities in Bangladesh","volume":"7","author":"Williams","year":"2019","journal-title":"Glob Health Sci Pract"}],"container-title":["Frontiers in Reproductive Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frph.2026.1911083\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T09:40:32Z","timestamp":1789033232000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frph.2026.1911083\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,10]]},"references-count":30,"alternative-id":["10.3389\/frph.2026.1911083"],"URL":"https:\/\/doi.org\/10.3389\/frph.2026.1911083","relation":{},"ISSN":["2673-3153"],"issn-type":[{"value":"2673-3153","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,10]]},"article-number":"1911083"}}