Team-Based Goals and Incentives for Community-Based Health Workers to Promote Maternal and Child Health in Bihar, India

Not Applicable

Completed

• Conditions: Healthy
• Interventions: Behavioral: Team-Based Goals and Incentives; Other: Control Condition

• Registration Number: NCT03561012
• Lead Sponsor: Stanford University

Brief Summary

This study is designed to evaluate the impact of team-based goals and performance-based incentives for community-based health workers on health-promoting behaviors among women related to reproductive, maternal, newborn and child health and nutrition in Bihar, India.

The intervention was funded by the Bill and Melinda Gates Foundation (BMGF) and implemented from 2012 to 2014. Health sub-centers in the catchment areas of five blocks (sub-districts) of the district of Bengusarai were randomly assigned to treatment or control arms (38 sub-centers were assigned to each). Data were collected in the Intervention and Control areas from mothers of infants 0-12 months at baseline and at 2.5-year follow-up, to assess the intervention's effects on quality and quantity of FLW home visits, postnatal health behaviors, and among older infants/toddlers, complementary feeding and vaccination. Difference in difference analyses were used to assess outcome effects in this quasi experimental study.

The TBGI intervention was implemented in areas where the BMGF-funded Ananya program (official title: Bihar Family Health Initiative) was also being implemented. Thus, the impact is of the \[TBGI intervention + Ananya\] versus \[Ananya alone\]. The Ananya program was developed and implemented via a partnership of BMGF and the Government of Bihar. The ultimate purpose of Ananya was to reduce maternal, newborn, and child mortality; fertility; and child undernutrition in Bihar, India. Ananya involved multi-level interventions designed to build front line health worker (FLW) capacities and reach to communities and households, as well as to strengthen public health facilities and quality of care to improve maternal and neonatal care and health behaviors, and thus survival. It was implemented from 2012 to 2014. Eight focal districts in western and central Bihar received Ananya, while 30 districts did not.

Detailed Description

Not available

Study Timeline

• Study Start: 2012-01-01
• Primary Completion: 2014-11-30
• Study Completion: 2014-11-30
• Study First Submitted: 2018-06-06
• Study First Submitted QC: 2018-06-06
• Study First Posted: 2018-06-19
• Status Verified: 2023-04
• Last Update Submitted: 2023-04-17
• Last Update Posted: 2023-04-19

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Female
• Target Recruitment: 3581

Inclusion Criteria

• Mothers of infants 0-12 months residing in the catchment area of the subcenters (public health facilities)

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Exclusion Criteria

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Intervention arm	Team-Based Goals and Incentives	-
Control Arm	Control Condition	-

Primary Outcome Measures

Name	Time	Method
At least 2 antenatal home visits in final trimester	Up to 2.5 years	Assessed via self-report from representative sample of mothers of children aged 0-11 months.
Current use of any modern method of contraception:	2.5 year follow-up	Assessed via self-report from representative sample of mothers of children aged 0-11 months.
At least one home visit within 24 hours of delivery, among women who had a home delivery	2.5 year follow-up	Assessed via self-report from representative sample of mothers of children aged 0-11 months.
Infant age 6-11 months old ate cereal-based meal in previous day	2.5 year follow-up	Assessed via self-report from representative sample of mothers of children aged 6-11 months.
Postpartum family planning home visits	2.5 year follow-up	Assessed via self-report from representative sample of mothers of children aged 0-11 months.
Nothing applied to the cord after cutting	2.5 year follow-up	Assessed via self-report from representative sample of mothers of children aged 0-11 months.
Complementary feeding home visit for women with infant 6-11 months old	2.5 year follow-up	Assessed via self-report from representative sample of mothers of children aged 0-11 months.
Obtained phone number for delivery (Frontline worker's (FLW) number, number for private vehicle, number for ambulance, any of the above)	2.5 year follow-up	Assessed via self-report from representative sample of mothers of children aged 0-11 months.
Received 90 IFA tablets	2.5 year follow-up	Assessed via self-report from representative sample of mothers of children aged 0-11 months.
Child age 6-11 months old received DPT3 vaccination	2.5 year follow-up	Assessed via self-report from representative sample of mothers of children aged 6-11 months.
At least one home visit within 1 week of delivery	2.5 year follow-up	Assessed via self-report from representative sample of mothers of children aged 0-11 months.
Immediate breastfeeding (within 1 hour of delivery)	2.5 year follow-up	Assessed via self-report from representative sample of mothers of children aged 0-11 months.