Use of Mobile Technology to Improve the Performance of Community-Based Health Workers in Promoting Reproductive, Maternal, Newborn and Child Health and Nutrition Behaviors in Bihar, India: A Cluster Randomized Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 3,112
- 主要终点
- Receipt of any postnatal home visits from an FLW (in the first 24 hours at home after delivery and in first month following delivery), using maternal survey response
研究概览
简要总结
This study is designed to evaluate the impact of use of mobile technology by 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 in collaboration with CARE was implemented from 2012 to 2014. Health sub-centers in the catchment areas of four blocks (sub-districts) of the district of Saharsa were randomly assigned to treatment or control arms (35 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-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 ICT-CCS 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 [ICT-CCS intervention + Ananya] versus [Ananya alone]. The Ananya program was developed and implemented via a partnership of BMGF, CARE, 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.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 15 Years 至 65 Years（Child, Adult, Older Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •Mothers of infants 0-12 months residing in the catchment area of the subcenters
排除标准
- 未提供
研究组 & 干预措施
Intervention arm
干预措施: Information Communication Technology Continuum of Care Service (Behavioral)
Control Arm
干预措施: Control Condition (Other)
结局指标
主要结局
Receipt of any postnatal home visits from an FLW (in the first 24 hours at home after delivery and in first month following delivery), using maternal survey response
时间窗: 2 year follow-up
Assessed via self-report from representative sample of mothers of children aged 0-11 months; items created for Ananya Survey.
Kangaroo Mother Care (skin to skin care)
时间窗: 2 year follow-up
Assessed via self-report from representative sample of mothers of children aged 0-11 months
Nothing applied to cord or umbilicus
时间窗: 2 year follow-up
Assessed via self-report from representative sample of mothers of children aged 0-11 months
Any complementary feeding of solid or semisolid food for infants aged 6-11 months, using maternal survey response
时间窗: 2 year follow-up
A survey item was used to assess complementary feeding of infants as reported by mothers of infants aged 0-11 months; items created for Ananya Survey.
Receipt of iron-folic acid tablets by month 4 and consumption of at least 90 tablets, using maternal survey response
时间窗: 2 year follow-up
Assessed via self-report from representative sample of mothers of children aged 0-11 months; item created for Ananya Survey.
Clean Cord Care
时间窗: 2 year follow-up
Assessed via self-report from representative sample of mothers of children aged 0-11 months
Delayed Bath
时间窗: 2 year follow-up
Assessed via self-report from representative sample of mothers of children aged 0-11 months
Initiation of Breastfeeding
时间窗: 2 year follow-up
Assessed via self-report from representative sample of mothers of children aged 0-11 months
Immunizations
时间窗: 2 year follow-up
Receipt of DBT1 and DBT3 for infants 6-11 mo; receipt of DPT3 and measles vaccine for children 12-23 months; maternal receipt of at least 2 tetanus vaccines using immunization cards or maternal self-report if not card. Data from immunization cards or from self-reports when women did not have cards; approximately 50-60% of participants did not have immunization cards
Health worker placed child unclothed on mother's chest/abdomen in skin-to-skin contact
时间窗: 2 year follow-up
Assessed via self-report from representative sample of mothers of children aged 0-11 months
Breastfed child within one hour of birth
时间窗: 2 year follow-up
Assessed via self-report from representative sample of mothers of children aged 0-11 months
Receipt of two or more home visits from an FLW in the final trimester of pregnancy and delivery at a facility (versus home birth), using maternal survey response
时间窗: 2 year follow-up
Assessed via self-report from representative sample of mothers of children aged 0-11 months; item created for Ananya Survey
First bath delayed by two or more days
时间窗: 2 year follow-up
Assessed via self-report from representative sample of mothers of children aged 0-11 months
次要结局
未报告次要终点
研究者
Gary Darmstadt
Associate Dean for Maternal and Child Health
Stanford University