Guideline adherence to aspirin prophylaxis use for preeclampsia among healthcare providers in Northwest Ethiopia: an explanatory sequential mixed-methods study

BACKGROUND: Preeclampsia is a significant cause of illness and mortality among mothers and newborns, especially in countries with limited resources. Preeclampsia is less common when low-dose aspirin (LDA) is used early in high-risk pregnancies. OBJECTIVE: The purpose of this study was to evaluate aspirin prophylaxis guideline adherence among Northwest Ethiopian healthcare providers (HCPs). STUDY DESIGN: A sequential mixed-methods explanatory research was carried out in three tertiary hospitals between March and May of 2025. Using a standardized questionnaire based on WHO, ACOG, and NICE standards, quantitative data was gathered from 304 HCPs who were chosen at random. Logistic regression was used to examine adherence-related characteristics. Qualitative perspectives were investigated through in-depth interviews with providers who were specifically chosen. RESULTS: Among 304 participants (mean age 29.8 ± 4.7 years; 56.6% male), nurses (38.2%) and midwives (32.6%) predominated. Only 41.4% had adequate knowledge, 54.3% held a positive attitude, and 34.9% exhibited good adherence to guidelines. Poor knowledge (AOR = 3.42), negative/uncertain attitude (AOR = 2.67), and