Measuring Ethnic Disparities in Family Planning Services in Peru
- Conditions
- Quality of Health Care
- Interventions
- Behavioral: Indigenous profileBehavioral: Mestizo profile
- Registration Number
- NCT01885858
- Lead Sponsor
- Universidad Peruana Cayetano Heredia
- Brief Summary
This study is designed as a crossover randomized controlled trial, to investigate the effects of client's ethnic characteristics on the quality of family planning services.
- Detailed Description
The study aims at evaluating, in a causal way, whether health providers in Peru might be contributing to ethnic health disparities in the provision of family planning services. We perform a field experiment that combines audit studies and simulated patient methodologies. The study population consists of clinics in Metropolitan Lima that are administered by the Ministry of Health and which provide family planning counseling services. The sample in our study includes 351 clinics. The primary outcome measured in the study was a composite of service provider compliance to guideline technical tasks in family planning counseling. We pre-defined indigenous and mestizo profiles using distinctive cultural attributes such as clothing, styling of hair, posture and patterns of speech. With a 1:1 allocation as per a computer generated randomization schedule, and using permuted blocks of four, clinics were assigned to a sequence of ethnic profiles, either to receive the indigenous then the mestizo profile (sequence 1) or mestizo and then the indigenous profile (sequence 2) in two periods. The trial comprises two treatment periods each of five week's duration. The second treatment period followed the same sequence of visits than the first one to obtain at least a five-week 'wash-out' period to mask the study.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 351
- Clinic operated by the Ministry of Health
- Clinic must provide family planning services
- Primary health clinics with the lowest degree of specialization (categorized as I-1) and thus lacking the number of patients required to enable the simulated patient to pass through the facilities undetected.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- CROSSOVER
- Arm && Interventions
Group Intervention Description Sequence 1 Indigenous profile Clinics receive first the indigenous and then the mestizo profile. Sequence 1 Mestizo profile Clinics receive first the indigenous and then the mestizo profile. Sequence 2 Indigenous profile Clinics receive first the mestizo and then the indigenous profile. Sequence 2 Mestizo profile Clinics receive first the mestizo and then the indigenous profile.
- Primary Outcome Measures
Name Time Method Mean differences between ethnic profiles in the proportion of items on which providers exchanged information with simulated patients during counseling session within the first 30 minutes after counseling session
- Secondary Outcome Measures
Name Time Method Mean differences between ethnic profiles in the length of visit to the clinic Within the first 30 minutes after counseling session Mean differences between ethnic profiles in the length counseling session Within the first 30 minutes after counseling session Mean differences between ethnic profiles in costs of appointment for counseling session Within the first 30 minutes after counseling session Mean differences between ethnic profiles in the proportion of items on which providers complied with standards of interpersonal relations during counseling session Within the first 30 minutes after counseling session