[Insert Table 2 here]
Free text-responses in the first-round highlighted the roles of primary care physicians in HDP management and the most prominent theme emerging in the analysis was authority (with 219 quotes). Most participants believed that primary care have responsibilities to conduct antenatal care (ANC), identify women with increased risks of HDP and refer patients who are at risk to obstetricians. They also had to not only provide HDP clinical management in primary care but also care coordination with hospitals.
The participants also conceded that routine ANC had already well applied in Indonesian primary care practice and blood pressure monitoring and dipstick urine tests been routinely conducted to screen for preeclampsia. However, some participants claimed that primary care had limited resources available in practice. For instance, only nifedipine was available as a treatment for pregnancy hypertension and the doctors’ limited time for pregnancy consultation.
Interestingly, many of the clinician participants also indicated their own doubt with the quality of HDP management they currently provide in practice, particularly the referral timing and patient monitoring procedures. They also expected guidance and skills upgrades on such HDP management in primary care (Table 3).