Effectiveness of an HIV-adapted IMCI Training and Supervision Programme for Community Health Workers

Not Applicable

Completed

• Conditions: Antenatal Health Care Utilization; Prevention of Mother-to-child Transmission of HIV; Postnatal Health Care Utilization; Infant Feeding Practices
• Interventions: Behavioral: Enhanced HIV and MCH training for CHW

• Registration Number: NCT01774136
• Lead Sponsor: University of KwaZulu

Brief Summary

This is a cluster randomized controlled trial (C-RCT) to evaluate the effectiveness of a Community-Integrated Management of Childhood Illness (C-IMCI) training for community caregivers (CCGs), adapted to include HIV-related interventions, on the delivery of maternal, newborn and child health interventions within households in rural communities in Ugu District, KwaZulu-Natal (KZN) Province, South Africa. The intervention includes two components: (1) a 2-week HIV/C-IMCI training for CCGs and their associated facilitators and supervisors, and (2) continuous support and supervision following the continuous quality improvement (CQI) framework, a low-technology approach to management and supervision of health programs. The primary objectives of the proposed evaluation are to measure the effect of the intervention on key outcomes, including early uptake of antenatal care, facility based delivery, postnatal visits, coverage of exclusive breastfeeding, and uptake of HIV PCR testing in infants at 6 weeks. We will also examine the effects of the intervention on immunization uptake up to 12 months and knowledge and practices of CCGs and mothers pertaining to maternal, newborn and child health.

Detailed Description

Not available

Study Timeline

• Study Start: 2012-04
• Study First Submitted: 2013-01-20
• Study First Submitted QC: 2013-01-20
• Study First Posted: 2013-01-23
• Primary Completion: 2014-04
• Study Completion: 2014-04
• Status Verified: 2019-04
• Last Update Submitted: 2019-04-16
• Last Update Posted: 2019-04-17

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 1342

Inclusion Criteria

Community caregivers

• CCGs who work in Ugu District
• age 18 years or older
• with grade 9 education or greater

Mothers

• Mothers age 18 years and older who delivered a live-born infant within the prior 12 months
• Reside in households served by participating CCGs.

Exclusion Criteria

• None

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Enhanced HIV and MCH training for CHW	Enhanced HIV and MCH training for CHW	The intervention includes two components: (1) a 2-week HIV/C-IMCI training for CCGs and their associated facilitators and supervisors, and (2) continuous support and supervision following the continuous quality improvement (CQI) framework, a low-technology approach to management and supervision of health programs.

Primary Outcome Measures

Name	Time	Method
Prevalence of antenatal booking before 20 weeks gestation	1 year
Prevalence of presentation for post-natal care within 7 days of delivery	1 year
Prevalence of exclusive breast-feeding practice at 14 weeks	1 year
Coverage of HIV PCR testing at 6 weeks	1 year

Secondary Outcome Measures

Name	Time	Method
Prevalence of exclusive breast-feeding practice at 6 months	1 year
Proportion of women who attended for antenatal care at least 4 times in pregnancy	1 year
Proportion of deliveries by skilled birth attendant at a health facility	1 year
Proportion of age-eligible infants who received recommended immunizations at 6, 10, and 14 weeks and 9 and 12 months	1 year
Proportion of children whose growth was monitored by CCG at home	1 year
Proportion of women without known HIV-positive status who received HIV test in pregnancy	1 year
Proportion of women without known HIV-positive status who received HIV test result in pregnancy	1 year
Proportion of HIV-positive women who received CD4 test results	1 year
Proportion of HIV-positive women who received ARV prophylaxis in pregnancy and during delivery	1 year
Proportion of infants born to HIV-positive mothers who received ARV prophylaxis following birth (including during breastfeeding where appropriate)	1 year
Knowledge and practices of mothers in the community regarding: infant feeding, HIV, availability of interventions to reduce HIV transmission, newborn care practices and recognition of serious illness in children and management of childhood illnesses	1 year
Knowledge and practices of CCGs with regards to: HIV-specific interventions to improve maternal health, reduce HIV transmission and improve child survival	1 year

Trial Locations

Locations (1)

20000+ Partnership, UKZN; 🇿🇦 Durban, KwaZulu-Natal, South Africa