Postpartum Empowerment: an Integrated Approach Driving Demand and Delivery of High Quality, Low-cost Postnatal Services in Kenya
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Enrollment
- 109
- Locations
- 1
- Primary Endpoint
- Complications detected
Study Overview
Brief Summary
This research represents a randomized trial of a program to improve timely postnatal care, comparing post-natal check-ups performed by community health workers delivered either by phone or in person to a control group. The study hypothesis is that when community health workers check on women three days after their delivery we will see improvements in the detection of maternal and child complications, better knowledge of complications and an increase in behaviors that are expected to lead to improved maternal and child health.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Factorial
- Primary Purpose
- Basic Science
Eligibility Criteria
- Ages
- 18 Years to 40 Years (Adult)
- Sex
- Female
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Women between 18 and 40 years old are eligible for inclusion if they have had a safe normal delivery of a live infant delivery at a Jacaranda Health facility. Eligible women must reside in a 20 km radius from the Jacaranda Health's hospital facility in peri-urban Nairobi. Women must provide a phone number to where they expect that can be reached 2 weeks postpartum.
Exclusion Criteria
- •Women who elect to leave the Jacaranda Health facility before the recommended 24 hours, against medical advice, postpartum are not eligible to participate in the postpartum care study. Women and their newborns who are referred to another hospital for higher level emergency obstetric or neonatal care will not be eligible to participate. Women who relocate outside the defined geographic area surrounding the hospital after their delivery are also not eligible.
Outcomes
Primary Outcomes
Complications detected
Time Frame: 3 days after delivery
Any maternal complications detected Number of maternal complications detected Any newborn complications detected Number of newborn complications detected
Successful referrals
Time Frame: 10 days after delivery (survey and administrative records)
If CHW made referral on day 3 for baby, respondent went to health facility If CHW made referral on day 3 for mother, respondent went to health facility
Care Seeking Behavior around complications and well baby check-up
Time Frame: 10 days after delivery (survey)
Brought baby to health facility for a well-baby check up If maternal complications (self-reported) in past week, visited or called health facility If baby complications (self-reported) in past week, visited or called health facility
Knowledge of danger signs
Time Frame: 10 days after delivery (survey)
Can name any maternal danger signs for which care should be sought (at day 10) Number of maternal danger signs named for which care should be sought (at day 10). Note: if mother lists "other" danger signs not coded, these should be coded as appropriate danger signs for which care should be sought or not Can name any baby danger signs for which care should be sought (at day 10) Number of baby danger signs named for which care should be sought (at day 10). Note: if mother lists "other" danger signs not coded, these should be coded as appropriate danger signs for which care should be sought or not
Breastfeeding
Time Frame: 10 days and 9 weeks after delivery (survey)
Fed only breastmilk in past week
Secondary Outcomes
- Referrals(3 days after delivery (from admin records))
- Feeding behavior(10 days 9 week after delivery (survey))
- Care seeking regarding breastfeeding, vaccines and child wellness(10 days and 9 weeks after delivery (survey))
- Knowledge of feeding and safety(10 days after delivery (survey))
- Care seeking at Jacaranda Health(10 days after delivery (survey))
Investigators
Margaret McConnell
Assistant Professor of Global Health Economics
Harvard School of Public Health (HSPH)