Please select the eligibility criteria that correspond to the clinical trial below.
Title: A Matched Pair Cluster-randomized Implementation Study to Measure the Effectiveness of an Intervention Package Aiming to Decrease Perinatal Mortality and Increase Institution-based Obstetric Care Among Indigenous Populations in Guatemala
Brief Summary: A matched pair cluster-randomized trial of this intervention package will be conducted in four rural and indigenous districts (Huehuetenango, Quiche, Alta Verapaz and San Marcos) of the Republic of Guatemala, using the health clinic as the unit of randomization. No external intervention is planned for control facilities, although enhanced monitoring, surveillance and data collection will occur throughout the study in all facilities in the four districts.

The package includes 3 interventions: 1) To train health care professionals in emergency obstetric and perinatal care using an innovative high-fidelity, low-tech, in situ, multidisciplinary simulation training curriculum (PRONTO); 2) To design and implement a social marketing strategy that promotes institution-based delivery; and 3) To integrate the role of obstetric nurse and professional midwife in intervention communities to act as liaisons between traditional birth attendants (TBA) and public health units. A fourth, cross-cutting component involves ongoing analysis, monitoring, surveillance and evaluation to strengthen information systems and monitor perinatal outcomes throughout the two years of the study.


Options:
A: Inclusion Criteria:

* Individuals: Investigators will include in the analysis the birth outcomes of all women accessing delivery care services at selected hospitals with gestational age of \> 24 weeks who are either admitted for labor or for hospitalization for another antenatal complication (preeclampsia, chorioamnionitis) or referred to a tertiary hospital. Women will be presenting at either control or intervention sites and their delivery information will be reviewed. For follow-up, the investigators will select women with infants born at greater than 1000 grams and less than 2500 grams, or between 2501 and 2999 grams with documented gestational age less than 37 weeks.
B: Inclusion Criteria:

* rural women
* indigenous
* poor
* Facilities at rural area
* Clinic attending vaginal deliveries

Exclusion Criteria:

* Facilities considered too close geographically to risk contamination of intervention to control facilities
* Clinics visits by pregnant women who present to intervention or control clinics for reasons other that an obstetric event
* Clinic or hospital visits by women who present to intervention or control clinics in the post partum period
C: Inclusion Criteria:

* delivery at a participating hospital between 12/31/02-03/31/04
* pregnancy of 20-43 weeks gestation

Exclusion Criteria:

* delivery at less than 20 weeks or greater than 43 weeks
D: Inclusion Criteria:

* Health-care professionals (specialised obstetricians, trainee obstetricians, midwifes, auxiliary nurses, specialised anaesthetists, trainee anaesthetists, anaesthesia nurses, and surgical nurses) employed at the Obstetric or Anaesthesia departments at Rigshospitalet and trainee doctors having part of their training programme at Juliane Marie Centre for children, women and reproduction, Rigshospitalet.
* Participants shall work in the evening-, night- and weekend-shift duties with some of their work in labour ward
* Provide signed informed consent before randomisation

Exclusion Criteria:

* Manager with staff responsibilities. Staff taking part in planning of the intervention.
* Lack of informed consent

Answer: B