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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
Harvard School of Public Health (HSPH)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Maternal Death

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

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

    First Posted
    October 14, 2016
    Last Updated
    July 22, 2019
    Sponsor
    Harvard School of Public Health (HSPH)
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    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

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    Incentives for Postnatal Care Demand

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