Pathways development:
The HDP management pathways drafts had been developed from statements that reached consensus from the first and the second round survey. HDP management pathways drafts were presented in three flowcharts: (i) HDP diagnosis, (ii) HDP management, and (iii) HDP maternal surveillance flowchart in primary care. The HDP management pathway itself was divided into five sections: (i) screening for preeclampsia risk factors at the first pregnancy visit, (ii) HDP screening activities during routine ANC, (iii) HDP management and monitoring, (iv) delivery plans for women with HDP, and (v) postpartum follow up for women with HDP in primary care.
The project investigators also considered and discussed statements that had not achieved consensus at the first and second round survey. The pathways accomodated statements related to contraception and antihypertensive medication used for women with HDP history were later accommodated using information tables (that are not included in this publication). Another statements were also considered not to be re-tested in the third-round survey, i.e IVF as isk factor for preeclampsia.

Third-round

Most participants agreed on the HDP management pathway drafts. The pathways’ agreement scores ranged from 78.4% for HDP monitoring to 89.2 % for preeclampsia risk factors screening (Table 2). Eleven participants revised their response on statement that had not received consensus at the previous rounds. Their revised responses, however, only changed agreement score for platelet count as baseline data for pregnant women with risks of preeclampsia (from 68.2% to 70.8%). The complete final agreement score for each statement and the diagnosis flowchart are attached as supplementary materials.
There were participants opinions and suggestions obtained from the third-round free text questions. Spme participants suggested improvement on the triage for pregnant women. A participant expessed his disagreement on HDP pathway development through the survey. He mentioned that the pathways drafts were way too complicated and they should not be developed through surveys. There were, again, a suggestion to differentiate management of mild and severe preeclampsia and further pressure to refer women with HDP to hospitals. Further suggestion was also obtained for the HDP surveillance pathway to respect on the patients’ confidentiality during patient management. It was previously mentioned at the surveillance pathways drafts that any HDP cases should be referred to public primary care clinics for surveillance data and be follow up by cadre home visits or receiving supports from community leaders. The suggestion on patient confidentiality was used to improve the statements listed in the surveillance pathway (Table 3).