Intrapartum intervention module

1.0 Overview 

Todo

Update this page to include the misoprostol intervention

This module in the intrapartum component determines coverage of intrapartum interventions, including azithromycin and corticosteroids (and eventually intrapartum sensors in wave II). Coverage availability/eligibility will depend on birth facility and believed gestational age.

2.0 Module Diagram and Data 

2.1 Module Diagram 

../../../../_images/intrapartum_intervention_module_diagram.drawio.png

2.2 Module Inputs 

Module required inputs
Input	Source module	Application	Note
Delivery facility	Facility choice	Determines intervention availability	Coverage of azithromycin and antenatal corticosteroids is delivery facility-specific (see decision nodes #1 and #3) Only home births are eligible for misoprostol intervention (decision node #5)
Believed gestational age	AI ultrasound	Affects antenatal corticosteroid coverage (decision node #2)	Only births believed to be preterm are eligible for coverage
ANC attendance	ANC attendance module	Determines misoprostol intervention eligibility (decision node #4)	Only those who attend ANC can receive misoprostol
RDS intervention propensity	Initial attributes module	Used to determine which simulants receive each RDS intervention (CPAP and ACS)

2.3 Module Decision Nodes 

Module decision nodes
Decision node	Description	Information	Note
1	Receives intrapartum azithromycin?	Scenario-dependent variable: intrapartum component scenario table for values (and baseline coverage section below for baseline coverage)
2	Believed to be preterm?	Believed gestational age (from pregnancy module output) < 37 weeks	Note necessary unit conversion between days and weeks
3	Receives antenatal corticosteroids	Scenario-dependent variable: intrapartum component scenario table for values (and baseline coverage section below for baseline coverage)
4	Attends ANC?	ANC attendance == True based on module input
5	Delivers at home?	Delivery facility == home based on module input

2.3.1 Baseline coverage

Misoprostol:

Please see the misoprostol intervention documentation page for baseline coverage values.

Intrapartum azithromycin:

Please see the azithromycin intervention documentation page for baseline coverage values for births at home and in BEmONC and CEmONC facilities.

Antenatal corticosteroids:

Please see the CPAP intervention documentation page for baseline coverage values for births at home and in BEmONC and CEmONC facilities. CPAP is a neonatal intervention, but like ACS, it treats RDS and we make the assumption that the coverage of ACS in the delivery facility is the same as the baseline coverage of CPAP in the delivery facility. See the ACS intervention documentation page for more information on this assumption.

Todo

Update terminology to be consistent with BEMONC/CEMONC?

2.4 Module Action Points 

Module action point
Action point	Description	Information
I	Record receipt of intrapartum azithromycin	Record to output
II	Record receipt of antenatal corticosteroids	Record to output
III	Record receipt of misoprostol	Record to output

2.4: Module Outputs 

Module outputs
Output	Value	Note
Intrapartum azithromycin coverage	True / False
Antenatal corticosteroid coverage	True / False	Coverage can only be True if gestational age is believed to be between 26 and 33 weeks
Misoprostol	True / False	Coverage can only be True if simulant attended ANC and delivered at home

3.0 Assumptions and limitations 

Todo

List module assumptions and limitations

4.0 Verification and Validation Criteria 

See the azithromycin intervention documentation page and the misoprostol intervention documentation page for V&V criteria.
Confirm no simulants believed to be outside of 26 and 33 weeks of gestational age at birth recieve corticosteroids