Evaluation of an mHealth Intervention to Improve Women's Access to Maternal Health Services in Rural Tanzania
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 572
- 主要终点
- Delivery in a facility
研究概览
简要总结
This study investigates whether training Community Health Workers (CHW) to use a smartphone-based prenatal counseling application as a "job aid" instead of the existing paper based standard is associated with increased women's use of maternal health services in Singida region, Tanzania.
详细描述
In low-income countries, frontline community health workers (CHWs) have potential to improve women's access to maternal health services through prenatal counseling and referral. However, CHW performance can often be enhanced with sufficient training, incentives, supportive supervision and job aids. Smartphone-based applications designed to assist CHWs with referrals, health education and client counseling may improve the quality of care delivered during household visits. There is a need for rigorous scientific studies on the impact of such interventions.
This study investigates whether CHWs' use of a smartphone-based application increases women's use of maternal health services in Singida region, Tanzania. It is hypothesized that smartphone-assisted counselling by CHWs can increase use of health facility-based delivery services compared to a control group of CHWs using standard paper-based protocols. This study is conducted within the context of larger project - SUSTAIN-MNCH Project (Supporting Systems to Improve Nutrition, Maternal, Newborn and Child Health), implemented by World Vision through multiple partners.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 16 Years 至 49 Years（Child, Adult）
- 性别
- Female
- 接受健康志愿者
- 是
入选标准
- •client of one of the CHWs enrolled in the mHealth study
- •visited at least once by a CHW following intervention (baseline training for CHWs) and during their most recent pregnancy
- •most recent delivery was a live birth and the child is still living
排除标准
- 未提供
研究组 & 干预措施
Control (paper based)
Women received prenatal household visits from CHWs who were trained on the Tanzania Ministry of Health and Social Welfare's National integrated Maternal, Newborn and Child Health (i-MNCH) paper-based protocols, i.e. received intervention "SUSTAIN Paperbased training of CHW (SOC)"
干预措施: SUSTAIN Paperbased training of CHW (SOC) (Behavioral)
Intervention (Smart phone assisted)
Women received prenatal household visits from CHWs trained on the following:
A) National i-MNCH programme; and B) Smartphone-assisted counseling protocol: a smartphone application designed to assist with identification of danger signs during pregnancy, referral to health facilities, and MNCH counseling
, i.e. received intervention "SUSTAIN Smartphone training of CHW (SP+)"
干预措施: SUSTAIN Paperbased training of CHW (SOC) (Behavioral)
Intervention (Smart phone assisted)
Women received prenatal household visits from CHWs trained on the following:
A) National i-MNCH programme; and B) Smartphone-assisted counseling protocol: a smartphone application designed to assist with identification of danger signs during pregnancy, referral to health facilities, and MNCH counseling
, i.e. received intervention "SUSTAIN Smartphone training of CHW (SP+)"
干预措施: SUSTAIN Smartphone training of CHW (SP+) (Behavioral)
结局指标
主要结局
Delivery in a facility
时间窗: Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months)
Participant delivered at or on the way to a health facility, measured by retrospective report at time of interview, after delivery
Antenatal care attendance
时间窗: Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months)
Whether participant attended 4 ANC visits or more during their most recent pregnancy
次要结局
- Gestational age at first contact/ANC(Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months))
- Iron supplementation during pregnancy(Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months))
- HIV screening HIV Screening(Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months))
- De-worming treatment during pregnancy(Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months))
- Bednet use(Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months))
- Malaria prophylaxis during pregnancy(Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months))
- Tetanus Toxoid Vaccination(Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months))
- Referrals(Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months))
- Referral uptake(Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months))
- Presence of partner at ANC(Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months))
- Birth plan(Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months))
- Early initiation of breastfeeding(Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months))
- Exclusive breastfeeding at 7 days(Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months))
- BCG vaccination(Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months))
- Maternal knowledge of danger signs during pregnancy(Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months))
研究者
Daniel Sellen
Professor
University of Toronto