Incentives for Postnatal Care Demand
Primary Purpose
Maternal Death, Neonatal Death
Status
Completed
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Performance-based monetary incentives
Sponsored by
About this trial
This is an interventional prevention trial for Maternal Death
Eligibility Criteria
Inclusion Criteria:
- community-based providers of antenatal and/or delivery care, and who are non-formally trained
- must be resident within the community
- must not plan to relocate over the intervention duration
- identified in partnership with community leadership
- be willing to participate fully in the study, including having their clients contacted for verification
Exclusion Criteria:
- plan to relocate over the intervention duration
- refusal to provide informed consent for the entire study protocol including agreeing to have their delivery clients contacted for verification
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
No Intervention
Experimental
Arm Label
Control arm
Referral incentive arm
Arm Description
Traditional birth attendants will receive an offer of two-weekly payouts per reported delivery they take that is verified by client.
Traditional birth attendants will receive an offer of two-weekly payouts per reported delivery they take that is verified by client. Traditional birth attendants randomized to this arm will also receive an offer of two-weekly payouts per successful referral of delivery clients to postnatal care within 48 hours of delivery in a facility if verified.
Outcomes
Primary Outcome Measures
Maternal Postnatal Care Referral
The proportion of delivery clients that are successfully referred by the traditional birth attendant for postnatal care within 48 hours of delivery. For each delivery client that the traditional birth attendant reported, we visited at least three days after delivery to ascertain if they had been asked to visit the postnatal clinic, clarify if they had visited the clinic within 48 hours of delivery, and what care they had received (if yes). The team visited traditional birth attendants every two weeks to identify new clients. Where a new client was not up to three days post-delivery, the interview was postponed until the next visit by the team to the community. This occurred repeatedly, over a five-month frame.
Secondary Outcome Measures
Neonatal Postnatal Care Referral
Proportion of neonates delivered by the traditional birth attendant that are successfully referred for postnatal care within 48 hours of delivery
Full Information
NCT ID
NCT02936869
First Posted
October 14, 2016
Last Updated
July 22, 2019
Sponsor
Harvard School of Public Health (HSPH)
1. Study Identification
Unique Protocol Identification Number
NCT02936869
Brief Title
Incentives for Postnatal Care Demand
Official Title
Incentives for Postnatal Care Demand
Study Type
Interventional
2. Study Status
Record Verification Date
July 2019
Overall Recruitment Status
Completed
Study Start Date
August 2016 (Actual)
Primary Completion Date
December 2016 (Actual)
Study Completion Date
December 2016 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Harvard School of Public Health (HSPH)
4. Oversight
5. Study Description
Brief Summary
The purpose of this study is to identify the causal impact of performance-based monetary incentives in increasing postnatal care (PNC) referrals by traditional birth attendants (TBAs), via a randomized controlled trial (RCT).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Maternal Death, Neonatal Death
7. Study Design
Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
207 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Control arm
Arm Type
No Intervention
Arm Description
Traditional birth attendants will receive an offer of two-weekly payouts per reported delivery they take that is verified by client.
Arm Title
Referral incentive arm
Arm Type
Experimental
Arm Description
Traditional birth attendants will receive an offer of two-weekly payouts per reported delivery they take that is verified by client.
Traditional birth attendants randomized to this arm will also receive an offer of two-weekly payouts per successful referral of delivery clients to postnatal care within 48 hours of delivery in a facility if verified.
Intervention Type
Behavioral
Intervention Name(s)
Performance-based monetary incentives
Primary Outcome Measure Information:
Title
Maternal Postnatal Care Referral
Description
The proportion of delivery clients that are successfully referred by the traditional birth attendant for postnatal care within 48 hours of delivery. For each delivery client that the traditional birth attendant reported, we visited at least three days after delivery to ascertain if they had been asked to visit the postnatal clinic, clarify if they had visited the clinic within 48 hours of delivery, and what care they had received (if yes). The team visited traditional birth attendants every two weeks to identify new clients. Where a new client was not up to three days post-delivery, the interview was postponed until the next visit by the team to the community. This occurred repeatedly, over a five-month frame.
Time Frame
Within 48 hours of delivery
Secondary Outcome Measure Information:
Title
Neonatal Postnatal Care Referral
Description
Proportion of neonates delivered by the traditional birth attendant that are successfully referred for postnatal care within 48 hours of delivery
Time Frame
Within 48 hours of delivery
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
community-based providers of antenatal and/or delivery care, and who are non-formally trained
must be resident within the community
must not plan to relocate over the intervention duration
identified in partnership with community leadership
be willing to participate fully in the study, including having their clients contacted for verification
Exclusion Criteria:
plan to relocate over the intervention duration
refusal to provide informed consent for the entire study protocol including agreeing to have their delivery clients contacted for verification
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Adanna Chukwuma, MBBS, MSc.
Organizational Affiliation
Harvard School of Public Health (HSPH)
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Margaret McConnell, PhD
Organizational Affiliation
Harvard School of Public Health (HSPH)
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Jessica Cohen, PhD
Organizational Affiliation
Harvard School of Public Health (HSPH)
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Chinyere Mbachu, MBBS, MPH
Organizational Affiliation
Health Policy Research Group
Official's Role
Principal Investigator
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
De-identified data for this study including all the variables used for the analysis are available for download on the Harvard Dataverse.
IPD Sharing Time Frame
The data on the Harvard Dataverse are available indefinitely as long as the website continues to host datasets.
IPD Sharing Access Criteria
The data can be freely downloaded without permission.
Citations:
PubMed Identifier
9509629
Citation
Itina SM. Characteristics of traditional birth attendants and their beliefs and practices in the Offot Clan, Nigeria. Bull World Health Organ. 1997;75(6):563-7.
Results Reference
background
PubMed Identifier
22895949
Citation
Sibley LM, Sipe TA, Barry D. Traditional birth attendant training for improving health behaviours and pregnancy outcomes. Cochrane Database Syst Rev. 2012 Aug 15;8(8):CD005460. doi: 10.1002/14651858.CD005460.pub3.
Results Reference
background
Citation
Oyebola, B. C., Muhammad, F., Otunomeruke, A., & Galadima, A. (2014). Effect of Performance-Based Incentives for Traditional Birth Attendants on Access to Maternal and Newborn Health-care Facilities in Gombe State, Nigeria: A Pilot Study. Meeting Abstract. Lancet.
Results Reference
background
Citation
WHO. (2004). Making Pregnancy Safer: The Critical Role of the Skilled Attendant - A Joint Statement by WHO, ICM, and FIGO. Geneva: World Health Organization.
Results Reference
background
PubMed Identifier
31104629
Citation
Chukwuma A, Mbachu C, McConnell M, Bossert TJ, Cohen J. The impact of monetary incentives on referrals by traditional birth attendants for postnatal care in Nigeria. BMC Pregnancy Childbirth. 2019 May 20;19(1):150. doi: 10.1186/s12884-019-2313-8.
Results Reference
derived
Learn more about this trial
Incentives for Postnatal Care Demand
We'll reach out to this number within 24 hrs