Grant: Doctoral: Vanier Canada Graduate Scholarships

Pre-eclampsia (PE), is defined as hypertension and proteinuria during pregnancy, a silent disease that may progress to Eclampsia (E) (i.e., clinically manifested by seizures) in the absence of medical interventions. It is a major contributor to maternal mortality or morbidity, and imposes substantial financial burdens on the families of pregnant women, their communities, and health care systems in the low-middle-income countries (LMICs). Recently, the Community Level Interventions for Preeclampsia (CLIP) Trial is evaluating a package of interventions addressing 'three delays' in triage, transport, and treatment to prevent maternal and perinatal deaths or severe morbidities in Pakistan. We hypothesize that the CLIP package of interventions, compared with routine pregnancy care is cost-effective in reducing combined maternal and perinatal mortality and severe morbidity. Using a societal perspective, we are interested in determining the costs to health care system, and costs to families of the pregnant women who are detected with high blood pressure during pregnancy in the intervention and control clusters. Additionally, qualitative focus groups will be conducted with pregnant women, their husbands' and trial implementing partners (i.e., care providers and policy makers) to help design the costing model, to conduct incremental cost-effectiveness analysis, and to support interpretation of economic analysis for decision makers in Pakistan. Potential outcomes of this study will play a pivotal role to inform health policy makers who are considering evidence of economic value along with the effectiveness of the CLIP package of interventions. Also, it will guide policy decisions on the allocation of resources for the post-trial program scale-up in Pakistan. In the long run, this study will propagate CLIP package of interventions as model of maternal health care for other LMICs in the region.