Community-Based Preeclampsia Screening by Midwives and Community Health Workers in Low- and Middle-Income Countries: A Scoping Review and Evidence-Informed Framework for Indonesia

Purpose: This scoping review mapped evidence on community-based preeclampsia screening delivered by midwives and community health workers (CHWs) in low- and middle-income countries (LMICs), identified implementation barriers and facilitators, and developed evidence-informed design requirements for an Indonesian community screening framework. Design and Methods: Guided by the Population-Concept-Context framework and reported in accordance with PRISMA-ScR, we searched PubMed, Scopus, and Web of Science for English-language studies published from 2016 to February 2026. A total of 133 records were identified across the databases. After deduplication and screening against prespecified eligibility criteria, nine studies were included in the scoping review. A structured data-charting form, informed by the review questions and Joanna Briggs Institute scoping-review guidance, was piloted using two purposefully selected studies before full extraction. Included evidence was mapped descriptively and synthesized thematically. Results: The included studies were conducted in Indonesia, Mozambique, Nigeria, India, Ecuador, South Africa, and other LMIC settings. The evidence, which was predominantly qualitative and mixed methods, suggested that community-level blood-pressure measurement, danger-sign assessment, simple decision support, and linkage to referral may be feasible and acceptable when supported by training, supervision, appropriate equipment, defined roles, documentation, and functional referral pathways. The evidence did not permit definitive conclusions about clinical effectiveness or safety across settings. Five implementation domains informed the proposed COMPREP Screen framework: workforce capability; tools and supplies; role clarity and accountability; documentation and data use; and referral-system functioning. Conclusion: Community-based screening led by midwives and CHWs may support earlier recognition of preeclampsia risk and timely linkage to facility-based assessment and care. Because the evidence base is limited and heterogeneous, COMPREP Screen should be regarded as an evidence-informed, context-sensitive framework that requires stakeholder validation and prospective implementation evaluation in Indonesia. Keywords: preeclampsia, community health workers, midwives, scoping review, antenatal care, low- and middle-income countries, referral