Structural Hinders to and Promoters of Good Maternal Care in Rural China
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Enrollment
- 108
- Locations
- 3
- Primary Endpoint
- Access to maternal health care
Study Overview
Brief Summary
This project aims to strengthen and improve the performance of health care system in rural China in order to improve maternal and child health. It also provides policy-makers and health service managers with evidence for the development of informed policy on maternal and child health (MCH). The research focuses on women of reproductive age in rural areas of China as well as on their antenatal and obstetric care service providers, both clinicians and policy makers. For the Member States and China, as well as other countries it will provide a comprehensive analysis and synthesis of current state of affairs, provider and user perspectives, of antenatal and obstetric care in rural China at national and local level. This study seeks to assess whether improving financial accessibility to and quality of maternal health care increase use of and impact of maternity services. This project is implemented in 3 provinces: Anhui, Shaan'xi and Chongqing. This project will provide a practical example and information on impact of abolishing user fees on MCH service utilisation and develop and disseminate evidence-based policy recommendations on how to improve access to and quality of antenatal and obstetrical care for local and central government and international organisations, and thus serve as a step toward reaching such important goals.
CHIMACA includes 3 types of interventions, two behavioural interventions and financial intervention. Behavioural interventions are training for clinical skills and training health education.
Detailed Description
Province of Chongqing:
Basic design: randomized townships (3 groups) comparing 2 different interventions to one randomised internal control group and one non-randomized external control group. In service-training:
- in service-training of clinical skills: Yes. In non-randomized setting, comparing in-service training to the external control group without training, and in randomized setting comparing in-service training to the internal control group without in-service training.
- in service-training of health education: Yes. In non-randomized setting, comparing in-service training to the external control group without training, and in randomized setting comparing in-service training to the internal control group without in-service training.
- Control groups: one randomized internal control group and one external non-randomised control group.
- 20 townships in Rongchang County are divided into 2 intervention groups and one internal control group (7 clusters)
- 6 townships in Tongliang County are randomly selected for an external control group
Province of Shaan'xi:
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Health Services Research
- Masking
- None
Eligibility Criteria
- Sex
- Female
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •townships with certain population size and distance to health care facilities
Exclusion Criteria
- •townships having another intervention in health care facilities
Arms & Interventions
Clinical skills training
In addition to financial coverage (CMS) extensive in-service training of clinical skills (CS) to all doctors and MCH workers at the village and township level.
Intervention: clinical skills training (Behavioral)
health education
In addition to financial coverage extensive in-service training of health education (HE) to all doctors and MCH workers at the village and township level(Anhui, Chongqing and Shaan'xi provinces); In addition to financial coverage extensive in-service training of health education (HE) for Family planning (FP) staff at village level (Anhui).
Intervention: health education (Behavioral)
Financial
In addition to financial coverage of MCH care within the local reimbursement system (CMS) the coverage of ante- and postnatal care.
Intervention: financial (Other)
Control
Financial coverage of MCH care within the local reimbursement system (CMS).
Outcomes
Primary Outcomes
Access to maternal health care
Time Frame: Up to 33 months
Secondary Outcomes
No secondary outcomes reported