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:

* Women \<29 weeks gestation
* No previous live births
* At least 2 socio-demographic risk characteristics; e.g. unmarried, \<12 years of education, unemployed.
B: Inclusion Criteria:

* 18 years or older, pregnant, and HIV+
* Enrolled in the PMTCT program at the study site clinic
* Receiving medical care from study site clinic
* Residing in study area for duration of study
* No psychosis, neurological damage, or IQ less than 70, as judged by an interviewer in consultation with a clinical supervisor
* Ability to give informed consent as judged by an interviewer

Exclusion Criteria:

* Less than 18 years, or not pregnant, or not HIV+
* Not enrolled in the PMTCT program at the study site clinic
* Not receiving medical care from study site clinic
* Not residing in study area for duration of study
* Psychosis, neurological damage, or IQ less than 70, as judged by an interviewer in consultation with a clinical supervisor
* Clinical provider (nurse or physician) believes it is not in the best interest of the MLH
* Unable to give informed consent
C: Inclusion Criteria:

* participants consenting for the home-based care model area
* participants who consent for household adequacy survey
* participants who consent from clinic care model area
D: 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

Answer: D