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Wakobo-ti-Kodro: Improving Identification of Pregnancy at Risk of Obstetric Complications at Community Level

Completed
Conditions
Maternal Health
Pregnancy Complications
Registration Number
NCT06613867
Lead Sponsor
Alliance for International Medical Action
Brief Summary

This project aims to improve maternal health indicators in a national context where the maternal mortality rate is one of the highest in the world. Our hypothesis is that an intervention combining (i) the training of traditional birth attendant in the identification and monitoring of high-risk pregnancies, (ii) their integration into the health system and (iii) the use of a digital decision-support application installed on a smartphone and adapted to their profile, could strengthen the identification and monitoring of high-risk pregnancies, increase attendance at facilities and thus the rate of assisted deliveries in health facilities, in Bimbo district around the capital Bangui in the Central African republic.

Detailed Description

This is a quasi-experimental study with a before (baseline measurement) and after (final measurement) approach combined with 2) an exploratory prospective observational cohort study and 3) a sub-study using a mixed methodology.

The main objective is to assess a composite intervention implementation combining the integration of Traditional Birth Attendants (TBAs) into the health system through a strengthened collaboration with health facilities with the support of a numeric application aiming at registering pregnant women \& identifying those at high risk of obstetric complications.

The secondary objectives are to:

1. Describe the characteristics of antenatal care, pregnancy outcomes, postnatal care, maternal and neonatal mortality, and changes in the use of health facilities by pregnant women.

2. To assess the acceptability and feasibility of this intervention with matrons, community health workers, community representatives, women who have already given birth in the study area and health staff involved in the study, in order to understand the potential levers and barriers to the implementation of the intervention.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
1857
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Deliveries in health facilities of women with complicated pregnanciesComparison between baseline and endline data after 10 months of intervention

Proportion of deliveries by pregnant women at risk of obstetric complications among all women who give birth in the health facilities included in the study, after 10 months of intervention

Secondary Outcome Measures
NameTimeMethod
Antenatal consultancies (ANCs)after 10 months of intervention

Evolution of monthly number of ANCs at health facilities

Deliveryafter 10 months of intervention

Evolution of monthly number of delivery at health facilities

Post-partum consultanciesafter 10 months of intervention

Evolution of monthly number of Post-partum consultancies at health facilities

Pregnant women at risk of obstetrical complication, screened by traditional birth attendants in the communityafter 10 months of intervention

Evolution of monthly number of Pregnant women at risk, screened by traditional birth attendants in the community

Pregnant women at risk of obstetrical complication, monitored at health facilitiesafter 10 months of intervention

Evolution of monthly number of Pregnant women at risk of obstetrical complication, monitored at health facilities

Maternal mortality rateafter 10 months of intervention

Number of death of women while pregnant or within 42 days of termination of pregnancy

Neonatal mortality rateafter 10 months of intervention

Death of a live born infant, regardless of gestational age at birth, within the first 28 completed days of life

Trial Locations

Locations (1)

Bimbo health center,

🇨🇫

Bimbo, Bangui, Central African Republic

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