scholarly journals Effectiveness of Checklist based Box system Interventions (CBBSI) versus routine care on improving utilization of Maternal Health Service in North West, Ethiopia: Cluster Randomized Controlled Trial

2019 ◽  
Author(s):  
Netsanet Belete ◽  
Mulusew Gerbaba ◽  
Gurmesa Tura
Keyword(s):  
Health Care ◽  
Randomized Controlled Trial ◽  
Maternal Health ◽  
Health Center ◽  
Controlled Trial ◽  
Maternal Health Service ◽  
Health Extension Workers ◽  
Randomized Controlled ◽  
Cluster Randomized ◽  
Pregnant Mothers

Abstract Background - Maternal mortality is still high in Ethiopia. Antenatal care, use of skilled delivery and postnatal care are key maternal health care services that can significantly reduce maternal mortality. However, in low and middle income countries including Ethiopia, utilization of these key services are not enough to deliver the recommended preventive, promotive and curative services. The aim of this study is to examine the effectiveness of checklist based box system interventions on improving maternal health service utilization. Methods - A community level cluster-randomized controlled trial will be conducted to compare the effectiveness of checklist based box system interventions over the routine standard of care. The intervention will use health extension program and provided by health extension workers and midwives, using a special type of health education scheduling and service utilization monitoring boxes, placed at health posts and health centers respectively. For this, 1,200 pregnant mothers, below 16 weeks of gestation, will be recruited from 30 clusters. Suspected pregnant mothers will be identified through a community survey and linked to the nearby health center. In a two weeks base, review of dropouts will be conducted at each intervention health center. Then intervention health posts (supervised by intervention health center) will be communicated for each dropout. Then, health extension workers will provide health education, using a person-centered manual prepared for this purpose. Data will be collected using ODK-Collect and analyzed using STATA version 13.0. Data will be analyzed by intention to treat analysis. Risk ration will be computed at cluster level and the summary will be compared using t-test. Outcomes between intervention and control groups will be compared with random effects logistic regression models. Discussion - The authors of this study expect that, the study will generate evidence on the effectiveness of checklist based box system interventions on improving utilization of maternal health care service, that are strong enough to inform policies in the country.

scholarly journals Effectiveness of Checklist based Box system Interventions (CBBSI) versus routine care on improving utilization of Maternal Health Service in North West, Ethiopia: Study protocol for a Cluster Randomized Controlled Trial

2019 ◽  
Author(s):  
Netsanet Belete ◽  
Mulusew Gerbaba ◽  
Gurmesa Tura
Keyword(s):  
Health Care ◽  
Randomized Controlled Trial ◽  
Maternal Health ◽  
Health Center ◽  
Controlled Trial ◽  
Maternal Health Service ◽  
Health Extension Workers ◽  
Randomized Controlled ◽  
Cluster Randomized ◽  
Pregnant Mothers

Abstract Background - Maternal mortality is still high in Ethiopia. Antenatal care, use of skilled delivery and postnatal care are key maternal health care services that can significantly reduce maternal mortality. However, in low and middle income countries including Ethiopia, utilization of these key services are not enough to deliver the recommended preventive, promotive and curative services. The aim of this study is to examine the effectiveness of checklist based box system interventions on improving maternal health service utilization. Methods - A community level cluster-randomized controlled trial will be conducted to compare the effectiveness of checklist based box system interventions over the routine standard of care. The intervention will use health extension program and provided by health extension workers and midwives, using a special type of health education scheduling and service utilization monitoring boxes, placed at health posts and health centers respectively. For this, 1,200 pregnant mothers, below 16 weeks of gestation, will be recruited from 30 clusters. Suspected pregnant mothers will be identified through a community survey and linked to the nearby health center. In a two weeks base, review of dropouts will be conducted at each intervention health center. Then intervention health posts (supervised by intervention health center) will be communicated for each dropout. Then, health extension workers will provide health education, using a person-centered manual prepared for this purpose. Data will be collected using ODK-Collect and analyzed using STATA version 13.0. Data will be analyzed by intention to treat analysis. Risk ration will be computed at cluster level and the summary will be compared using t-test. Outcomes between intervention and control groups will be compared with random effects logistic regression models. Discussion - The authors of this study expect that, the study will generate evidence on the effectiveness of checklist based box system interventions on improving utilization of maternal health care service, that are strong enough to inform policies in the country.

scholarly journals Effectiveness of Checklist based Box system Interventions (CBBSI) versus routine care on improving utilization of Maternal Health Service in North West, Ethiopia: Study protocol for a Cluster Randomized Controlled Trial

2019 ◽  
Author(s):  
Netsanet Belete ◽  
Mulusew Gerbaba ◽  
Gurmesa Tura
Keyword(s):  
Health Care ◽  
Randomized Controlled Trial ◽  
Maternal Health ◽  
Health Center ◽  
Controlled Trial ◽  
Maternal Health Service ◽  
Health Extension Workers ◽  
Randomized Controlled ◽  
Cluster Randomized ◽  
Pregnant Mothers

Abstract Background - Maternal mortality is still high in Ethiopia. Antenatal care, use of skilled delivery and postnatal care are key maternal health care services that can significantly reduce maternal mortality. However, in low and middle income countries including Ethiopia, utilization of these key services are not enough to deliver the recommended preventive, promotive and curative services. The aim of this study is to examine the effectiveness of checklist based box system interventions on improving maternal health service utilization. Methods - A community level cluster-randomized controlled trial will be conducted to compare the effectiveness of checklist based box system interventions over the routine standard of care. The intervention will use health extension program and provided by health extension workers and midwives, using a special type of health education scheduling and service utilization monitoring boxes, placed at health posts and health centers respectively. For this, 1,200 pregnant mothers, below 16 weeks of gestation, will be recruited from 30 clusters. Suspected pregnant mothers will be identified through a community survey and linked to the nearby health center. In a two weeks base, review of dropouts will be conducted at each intervention health center. Then intervention health posts (supervised by intervention health center) will be communicated for each dropout. Then, health extension workers will provide health education, using a person-centered manual prepared for this purpose. Data will be collected using ODK-Collect and analyzed using STATA version 13.0. Data will be analyzed by intention to treat analysis. Risk ration will be computed at cluster level and the summary will be compared using t-test. Outcomes between intervention and control groups will be compared with random effects logistic regression models. Discussion - The authors of this study expect that, the study will generate evidence on the effectiveness of checklist based box system interventions on improving utilization of maternal health care service, that are strong enough to inform policies in the country.

scholarly journals Effectiveness of Checklist based Box system Interventions (CBBSI) versus routine care on improving utilization of Maternal Health Service in North West, Ethiopia: Study protocol for a Cluster Randomized Controlled Trial

2019 ◽  
Author(s):  
Netsanet Belete ◽  
Mulusew Gerbaba ◽  
Gurmesa Tura
Keyword(s):  
Randomized Controlled Trial ◽  
Maternal Health ◽  
Antenatal Care ◽  
Service Utilization ◽  
Postnatal Care ◽  
Controlled Trial ◽  
Cluster Randomized Controlled Trial ◽  
Maternal Health Service ◽  
Randomized Controlled ◽  
Cluster Randomized

Abstract Background-Maternal mortality is still high in Ethiopia. Antenatal care, use of skilled delivery and postnatal care are key maternal health care services that can significantly reduce maternal mortality. However, in low and middle-income countries including Ethiopia, utilization of these key services is limited, so that preventive, promotive and curative services are not provided as per the recommendation. The aim of this study is to examine the effectiveness of checklist based box system interventions on improving maternal health service utilization. Methods - A community level cluster-randomized controlled trial will be conducted to compare the effectiveness of checklist based box system interventions over the routine standard of care, as a control arm. The intervention will use health extension program and provided by health extension workers and midwives, using a special type of health education scheduling and service utilization monitoring boxes, placed at health posts and health centers respectively. For this, 1,200 pregnant mothers, below 16 weeks of gestation, will be recruited from 30 clusters. Suspected pregnant mothers will be identified through a community survey and linked to the nearby health center. With effective communication between health centers and health posts, dropout-tracing mechanisms are implemented to make mothers resume service utilization. Data will be collected using ODK-Collect and analyzed using STATA version 13.0. Data will be analyzed by intention to treat analysis. Risk ratio will be computed at cluster level and the summary will be compared using t-test. Outcomes between intervention and control groups will be compared with random effects logistic regression models. Achieving four antenatal care, health facility delivery and postnatal care visits at 6 weeks of delivery were treated as primary out comes for this study. Discussion - The authors of this study expect that, the study will generate evidence on the effectiveness of checklist based box system interventions on improving utilization of maternal health care service, that produce inputs for related policies in the country. Trial Registration – ClinicalTrials.gov NCT03891030, 26 March 2019, Retrospectively Registered Keywords - Box system, maternal health, Antenatal care, skilled delivery, postnatal care, cluster randomized controlled trial, Ethiopia

scholarly journals Group versus individual antenatal and first year postpartum care: Study protocol for a multi-country cluster randomized controlled trial in Kenya and Nigeria

2019 ◽  
Vol 2 ◽  
pp. 56 ◽  
Author(s):  
Mark M. Kabue ◽  
Lindsay Grenier ◽  
Stephanie Suhowatsky ◽  
Jaiyeola Oyetunji ◽  
Emmanuel Ugwa ◽  
...  
Keyword(s):  
Health Care ◽  
Randomized Controlled Trial ◽  
Data Collection ◽  
Pregnant Women ◽  
Controlled Trial ◽  
Phase 1 ◽  
First Year ◽  
Phase 2 ◽  
Randomized Controlled ◽  
Cluster Randomized

Background: Antenatal care (ANC) in many low- and middle-income countries is under-utilized and of sub-optimal quality. Group ANC (G-ANC) is an intervention designed to improve the experience and provision of ANC for groups of women (cohorts) at similar stages of pregnancy. Methods: A two-arm, two-phase, cluster randomized controlled trial (cRCT) (non-blinded) is being conducted in Kenya and Nigeria. Public health facilities were matched and randomized to either standard individual ANC (control) or G-ANC (intervention) prior to enrollment. Participants include pregnant women attending first ANC at gestational age <24 weeks, health care providers, and sub-national health managers. Enrollment ended in June 2017 for both countries. In the intervention arm, pregnant women are assigned to cohorts at first ANC visit and receive subsequent care together during five meetings facilitated by a health care provider (Phase 1). After birth, the same cohorts meet four times over 12 months with their babies (Phase 2). Data collection was performed through surveys, clinical data extraction, focus group discussions, and in-depth interviews. Phase 1 data collection ended in January 2018 and Phase 2 concludes in November 2018. Intention-to-treat analysis will be used to evaluate primary outcomes for Phases 1 and 2: health facility delivery and use of a modern method of family planning at 12 months postpartum, respectively. Data analysis and reporting of results will be consistent with norms for cRCTs. General estimating equation models that account for clustering will be employed for primary outcome analyzes. Results: Overall 1,075 and 1,013 pregnant women were enrolled in Nigeria and Kenya, respectively. Final study results will be available in February 2019. Conclusions: This is the first cRCT on G-ANC in Africa. It is among the first to examine the effects of continuing group care through the first year postpartum. Registration: Pan African Clinical Trials Registry PACTR201706002254227 May 02, 2017

scholarly journals Prevention of developmental delays among children at public healthcare facilities of Pakistan: protocol for a cluster Randomized Controlled Trial

2021 ◽  
Vol 20 (11) ◽  
Author(s):  
Nida Khan ◽  
Muhammad Amir Khan ◽  
Muhammad Ahmar Khan ◽  
Amna Ejaz ◽  
Azza Warraitch ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Randomized Controlled Trial ◽  
Developmental Delays ◽  
Controlled Trial ◽  
Cluster Randomized Controlled Trial ◽  
Public Health Care ◽  
Public Healthcare ◽  
Randomized Controlled ◽  
Cluster Randomized

Objectives: This cluster Randomized Controlled Trial (cRCT) aims to evaluate the effectiveness of an integrated ECD package in preventing developmental delays among children aged two years, in public health care centers, as compared to a control arm. Methods: This is a parallel, two-arm, cluster randomized controlled trial. 768 mother-child pairs (‘dyads’) attending any of the 24-public health centers in two districts of Pakistan will be recruited, with an average of 32 participants per cluster. In the intervention arm, ECD based counselling sessions will be delivered to mother–child dyads by trained staff at public health care centers. Our primary outcome is reduction in prevalence of two or more developmental delays among children, from 38% to 23% in the intervention arm. Unit of randomization will be public health care center. 24 eligible clusters recruited will be randomized into intervention and control arms, using 1:1 allocation. Discussion: The integrated model of child care into primary health care has the potential to provide a feasible and sustainable model for improving child developmental scale. Key words: Early Child Development; Prevention; Developmental Delays; Public healthcare facilities

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