Evaluation of a Community Engagement and Demand Creation Strategy for Childhood Diarrhea and Pneumonia in Pakistan
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 48
- 试验地点
- 1
- 主要终点
- ORS use for diarrhea
研究概览
简要总结
Childhood diarrhea and pneumonia remains the leading cause of mortality among children under five years of age in Pakistan. The prevalence of diarrhea in Pakistan has increased from 15% in 1990 to 23% in 2013 while there has been no progress in the prevalence of pneumonia and it has been almost constant over the last two decades. The coverage of preventive and therapeutic interventions for childhood diarrhea and pneumonia also remains low. This study aims to improve the adherence to recommended preventive and curative practices for childhood diarrhea and pneumonia.
详细描述
Study Components and Objectives:
This study will be conducted in two phases:
- Formative phase: The objective of this phase is to assess the existing care seeking practices and care provision for childhood diarrhea and pneumonia and identify the existing barriers and facilitators for care seeking for childhood diarrhea and pneumonia.
- Cluster Randomized Trial: (CoMIC Trial - Community Mobilization and Community Incentivization): The objective of this phase is to assess the impact of a community engagement and demand creation strategy involving an community-based incentive scheme on adherence to recommended preventive and curative practices for diarrhea and pneumonia among children under five years of age.
Study site: This study will be conducted in Tando Muhammad Khan, which is a rural district in the province of Sindh. This would a three and half year study with two year of intervention period.
Study design: This study will follow a mixed methodology approach with a formative research component followed by a prospective two arm cluster randomized controlled trial (cRCT).
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •People residing in the villages in the selected study site and consent to participate.
排除标准
- 未提供
研究组 & 干预措施
Control
This arm will receive the routine standard of care.
Community Mobilization
This arm will receive specific messages regarding the prevention and management of childhood diarrhea and pneumonia. The investigators will form village committees (VC) consisting of prominent members of the community (6-8 in a group) to carry out awareness and motivational activities for the uptake of the identified interventions.
干预措施: Community Mobilization and Community Incentive (Behavioral)
Community Mobilization
This arm will receive specific messages regarding the prevention and management of childhood diarrhea and pneumonia. The investigators will form village committees (VC) consisting of prominent members of the community (6-8 in a group) to carry out awareness and motivational activities for the uptake of the identified interventions.
干预措施: Community Mobilization (Behavioral)
Community Mobilization and Community Incentive
In this arm, along with the interventions in the community mobilization arm, community based incentives will also be provided. The clusters which improve the practices for preventive and curative strategies for diarrhea and pneumonia will receive community-based incentive including structural benefits linked to health including tube wells, water supply, toilets in community/schools, water storage facility or any other incentive as decided with the respective village committees.
干预措施: Community Mobilization and Community Incentive (Behavioral)
结局指标
主要结局
ORS use for diarrhea
时间窗: At 24 months of intervention
Age-appropriate immunization 12-23 months
时间窗: At 24 months of intervention
Mean Sanitation Index
时间窗: At 24 months of intervention
The scale is focused on 12 components. All the components are valued equally and can be scored '0' (for 'No') or '1' (for 'Yes'). These would be summed up for each household for a total possible score of 12 and a range of 0-12. Higher score represents a better outcome. It comprises of the following three subscales: 1. Drinking water - possible score of minimum 0 and maximum 3 * Interior water storage container is covered; * Exterior water storage container is cleaned; * Water present in water storage container 2. Food - possible score of minimum 0 and maximum 3 * Clean dishes are covered; * Clean dishes are kept high; * All food is covered 3. Domestic hygiene - possible score of minimum 0 and maximum 6 * No trash outside the house; * No trash inside the house; * No unrestrained animals in patio or house; * No accumulation of dirty clothes; * Insignificant number of flies in house; * No standing water in patio or around house
次要结局
- Handwashing with soap at important time(At 24 months of intervention)
- Prevalence of Diarrhea and pneumonia(At 24 months of intervention)
- Exclusive breastfeeding rates - children who are exclusively breastfed at 6 months of age(At 24 months of intervention)
- Total cost (unit cost and cost effectiveness)(At 24 months of intervention)
- Open defecation rates(At 24 months of intervention)
- Care seeking for severe cases of childhood diarrhea and pneumonia - parents/caregivers who sought care for child with diarrhea/pneumonia(At 24 months of intervention)
研究者
Dr Jai Kumar Das
Assistant Professor
Aga Khan University