An affordable solution for strengthening the backbone of maternal care during childbirth

• Register: ISRCTN
• Last refreshed on: 5 June 2017
• Main ID: ISRCTN14478662
• Date of registration: 11/05/2017
• Prospective Registration: No
• Primary sponsor: Georgia State University
• Public title: An affordable solution for strengthening the backbone of maternal care during childbirth
• Scientific title: Priming rural facilities for optimal service delivery
• Date of first enrolment: 01/03/2014
• Target sample size: 26280
• Recruitment status: Completed
• URL: http://isrctn.com/ISRCTN14478662
• Study type: Interventional
• Study design: Randomised cross over trial (Treatment)

Countries of recruitment

Pakistan

Contacts

• Name: Musharraf Cyan

Key inclusion & exclusion criteria

Inclusion criteria: 1. All maternal care health workers in the 72 health facilities
2. All pregnant women who applied to the 72 health facilities
Exclusion criteria: 1. No pregnant women attending rural health facilities
2. Women attending health facilities for ANC visits
3. Health workers at the health facilities not tasked with maternal care and/or EmOC services


Age minimum:
Age maximum:
Gender: Both

Health Condition(s) or Problem(s) studied

Maternal health
Pregnancy and Childbirth
Maternal health

Intervention(s)

Participants are randomized to receive the two study conditions in a random order using a randomization command in Stata. All the participating facilities are randomly assigned to eight groups and two time periods. All participants in a facility receive the treatment exposure or control treatment assigned to the facility. Groups are balanced with 9 facilities in each group. During time period 1, the first 6 months of the study, facilities in Groups 1, 2 and 3 receive 6 visits (1 monthly mentoring visit for 6 months) , 3 visits (1 mentoring visit once in 2 months), and 1 mentoring visit at the start of the time period, respectively. Facilities in Group 4, 5, 6, 7 and 8 do not receive any mentoring visit during the first 6 months. At 6 months, Groups 5, 6 and 7 are exposed to treatment while Groups 1, 2 and 3 move into control. Facilities in Group 5, 6 and 7 receive 6, 3 and 1 mentoring visit during time period 2. Facilities in Group 1, 2, 3, 4 and 8 are not exposed to mentoring visits in time period 2.

Control: Participants undergo basic training of health care workers. This involves a one-day refresher workshop on EmoC conducted by OBGYN specialists.

Intervention: Participants undergo the same basic training of health care workers as the control group, with the addition of mentoring visits through post graduate doctors. These visits involve onsite discussions and demonstration of EmOC methods.

Follow up takes place after 12 months and involves review of clinical management notes compiled from monthly facility records.

Primary Outcome(s)

Rate of application of emergency obstetric care management options is assessed by reviewing clinical management notes from baseline to 12 months.

Secondary Outcome(s)

1. Rate of application of appropriate diagnosis is assessed by reviewing clinical management notes from baseline to 12 months
2. Usage of parental antibiotics is assessed by reviewing clinical management notes from baseline to 12 months
3. Usage of uterotonic drugs is assessed by reviewing clinical management notes from baseline to 12 months
4. Knowledge, attitudes, and practices (KAP) scores are assessed by reviewing clinical management notes at 6 and 12 months

Secondary ID(s)

H14055

Source(s) of Monetary Support

International Food Policy Research Institute

Secondary Sponsor(s)

King Edward Medical University