Table 3.

Implications for research, policy and practice

Domain	List of questions
Guidelines and protocols	Are guidelines and clinical protocols on pre-eclampsia/eclampsia and calcium supplements during pregnancy consistent between WHO, national and facility-levels?
Knowledge and learning	Do women or healthcare providers have scepticism or concerns about adverse effects of calcium supplements during pregnancy that can be addressed? Do women and their family members receive education and educational materials about signs of pre-eclampsia/eclampsia early in pregnancy? Do women have sufficient time and opportunity to discuss pre-eclampsia/eclampsia with healthcare providers during antenatal care? Do women have sufficient time and opportunity to discuss calcium supplementation with healthcare providers during antenatal care, including addressing fears about side effects, managing side effects, safety concerns and reinforcing positive messaging about expected benefits? Have concerns from both women and healthcare providers about calcium supplements as a form of overmedicalisation of pregnancy been addressed in culturally appropriate ways? Have healthcare providers received in-service training on pre-eclampsia/eclampsia prevention and management, including the importance of calcium supplements during pregnancy for prevention?
Strategies to improve use	Do all relevant cadres of healthcare providers (including midwives and nurses) have authority to prescribe calcium supplements during pregnancy? Do women have the opportunity to try different types of calcium tablets to suit their preferences, such as chewable/non-chewable, different tastes and different size tablets? Do women have the opportunity to try different calcium dosing combinations to suit their schedules and preferences? For women experiencing or at risk of food insecurity during pregnancy, are there additional social services to support adequate nutrition intake during pregnancy? Have different types of reminder systems (eg, posters for home, calendars and integration into daily routines) been designed with women and their families to encourage use? Has support from family and/or adherence partners been integrated for women, and do family members or adherence partners have the opportunity to attend educational sessions? Are stocks of calcium readily available in the antenatal care wards? Is there sufficient funding and budget allocation to ensure continuous procurement and distribution of calcium supplements?