The proposed study will assess and implement a comprehensive antenatal HRP screening and telehealth follow-up program in rural Nepal. The main questions it aims to answer are: 1. To estimate the burden of HRPs using the existing Antenatal Risk-Score Checklist in rural Nepal 2. Assess acceptability, feasibility, preliminary effectiveness, and implementation outcomes of the HRP bundle at the primary healthcare in Nepal
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
100
The intervention would include 1. identification of high-risk pregnancy 2. Teleconsultation with expert consultant 3. weekly call with patient navigator 4. training of health care provider for HRP care, and 5. visits in the weekly prenatal telehealth clinic
Melamchi Primary Health Care Center
Melamchi, Bagmati, Nepal
Maternal Near Miss
life-threatening complication during pregnancy, childbirth, or within 42 days postpartum, but survives with appropriate medical intervention (We will use WHO criteria)
Time frame: up to 60 days postpartum
Neonatal death
Number of neonatal deaths, defined as death of a liveborn infant within the first 28 days of life
Time frame: Up to 28 days after birth
Low Apgar Score at 5 Minutes
Number of infants with an Apgar score less than 7 at 5 minutes after birth
Time frame: At 5 minutes after birth
Neonatal Intensive Care Unit Admission
Number of infants admitted to a neonatal intensive care unit
Time frame: Up to 30 days after birth
Need for Mechanical Ventilation
Number of infants requiring mechanical ventilation
Time frame: up to 30 days after birth
Neonatal Respiratory Distress Syndrome
Number of infants diagnosed with respiratory distress syndrome
Time frame: Up to 30 days after birth
Neonatal Hypoglycemia
Number of infants with hypoglycemia, defined as less than 45 mg/dl
Time frame: Up to 48 hours after birth
Low Birth Weight
Number of infants with birth weight less than 2500 grams
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: At birth
Composite Adverse Neonatal Outcome
Number of infants with at least one of the following: neonatal death, Apgar score less than 7 at 5 minutes, NICU admission, need for mechanical ventilation, respiratory distress syndrome, hypoglycemia
Time frame: up to 30 days after birth
Antenatal Risk Screening Rate
Proportion of pregnant women enrolled in the study who undergo antenatal risk screening using the Antenatal Risk-Score Checklist
Time frame: Up to 24 months
Referral Rate
Percentage of pregnant women referred to higher levels of care based on risks identified through antenatal risk screening
Time frame: Up to 24 months
Telehealth Consultation Utilization Rate
Proportion of pregnant women in the High Risk Pregnancy Bundle Intervention Arm who utilize at least 80% of their recommended telehealth consultations
Time frame: Up to 24 months