Accelerating Newborn Survival in Ghana Through a Low-dose, High-frequency Health Worker Training Approach

Not Applicable

Completed

• Conditions: Stillbirth; Neonatal Death
• Interventions: Behavioral: Active Comparison; Behavioral: Low dose high frequency health worker training approach

• Registration Number: NCT03290924
• Lead Sponsor: Jhpiego

Brief Summary

This study assesses the effect of a low-dose, high-frequency training approach on long-term evidence-based skill retention among skilled birth attendants and impact on adverse birth outcomes at hospitals in Ghana.

Detailed Description

In-service training for skilled birth attendants (SBAs) is one of the most common interventions to address lack of knowledge and skills. However, these training interventions are seldom evaluated for effectiveness in improving learning or performance.

This study study is a cluster-randomized waitlist trial implemented in 40 public and mission hospitals in Ghana. It assesses the effect of a low-dose, high-frequency (LDHF) training approach to update hospital-based SBAs in key evidence-based intrapartum and immediate newborn care practices, using current global guidelines.The LDHF approach includes two 4-day onsite sessions (low dose) with weekly practice sessions, SMS quizzes and reminders, and mentoring via mobile phone and onsite visits between trainings (high frequency). The low-dose sessions include competency acquisition through simulation, case-based learning, and small content packages spread over short time intervals.

Eligible hospitals will be stratified by geographic region and caseload, and then randomly assigned to one of four implementation waves. The pipeline randomization allows for rigorous evaluation while the program is rolled out to all facilities.

Study Timeline

• Study Start: 2014-09-01
• Primary Completion: 2017-02-28
• Study Completion: 2017-02-28
• Status Verified: 2017-09
• Study First Submitted: 2017-09-19
• Study First Submitted QC: 2017-09-19
• Last Update Submitted: 2017-09-21
• Study First Posted: 2017-09-25
• Last Update Posted: 2017-09-25

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 40

Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Comparison	Active Comparison	Training on data collection and reporting
Intervention	Low dose high frequency health worker training approach	Low-dose high-frequency health worker training approach to update skilled birth attendants in key evidence-based intrapartum and immediate newborn care practices

Primary Outcome Measures

Name	Time	Method
institutional intrapartum stillbirth rate	1 day	proportion of all facility births that resulted in intrapartum stillbirth
institutional twenty-four hour newborn mortality rate	1 day	death within 24 hours, or before discharge, of a newborn who breathed at birth

Secondary Outcome Measures

Name	Time	Method
skilled birth attendant knowledge and skills	Pre-test (before training) - post-test (immediately after training) - endline (12 months)	score on written and practical examinations on routine and emergency obstetric and newborn care