Antenatal High-Risk Pregnancy Intervention Bundle in Rural Nepal

life-threatening complication during pregnancy, childbirth, or within 42 days postpartum, but survives with appropriate medical intervention (We will use WHO criteria)

Number of neonatal deaths, defined as death of a liveborn infant within the first 28 days of life

Number of infants with an Apgar score less than 7 at 5 minutes after birth

Number of infants admitted to a neonatal intensive care unit

Number of infants requiring mechanical ventilation

Number of infants diagnosed with respiratory distress syndrome

Number of infants with hypoglycemia, defined as less than 45 mg/dl

Number of infants with birth weight less than 2500 grams

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

Proportion of pregnant women enrolled in the study who undergo antenatal risk screening using the Antenatal Risk-Score Checklist

Percentage of pregnant women referred to higher levels of care based on risks identified through antenatal risk screening

Proportion of pregnant women in the High Risk Pregnancy Bundle Intervention Arm who utilize at least 80% of their recommended telehealth consultations

We will assess the acceptability of each intervention component (risk-screening scoring system, teleconsultation, weekly patient navigator calls, and provider training) using the mean total score and standard deviation (SD) of the Acceptability of Intervention Measure (AIM), administered at both the patient and provider level.

We will assess the appropriateness of each intervention component (risk-screening scoring system, teleconsultation, weekly patient navigator calls, and provider training) using the mean total score and standard deviation (SD) of the Intervention Appropriateness Measure (IAM), administered at both the patient and provider level.

We will assess the feasibility of each intervention component (risk-screening scoring system, teleconsultation, weekly patient navigator calls, and provider training) using the mean total score and standard deviation (SD) of the Feasibility of Intervention Measure (FIM), administered at both the patient and provider level.