Please select the eligibility criteria that correspond to the clinical trial below.
Title: Evaluating the Effects of Clinical Decision Making Support Systems on Maternal and Neonatal Mortality and Morbidity in Ghana: a Cluster Randomized Controlled Trial
Brief Summary: Introduction Maternal and neonatal mortality continue to be to be prominent public health issues in sub Saharan Africa including Ghana, with slow progress made towards attainment of Millennium Development Goals (MDG) 4 \& 5. Studies have identified poor quality of maternal and child healthcare as a major challenge to the prevention of neonatal and maternal deaths. Effective interventions are required to make significant inroads in these areas.

Objective To evaluate the effect of a SMS text messaging intervention to support clinical decision making by frontline health care professionals on neonatal and maternal mortality.

Methods We propose to conduct a randomized controlled trial in the Eastern region of Ghana, involving 8 intervention and 8 control districts. The intervention consists of text messaging of standard protocols for maternal and neonatal care to front line health care providers in the region. A total of 17,040 pregnant women who are receiving care (including antenatal, delivery and post-natal) at any of the hospitals in the selected districts in the region will be monitored through monthly aggregate data on outcome measures such as neonatal and maternal deaths from eclampsia, postpartum haemorrhage, puerperal sepsis, birth asphyxia, low birth weight and neonatal sepsis. Cord sepsis will also be included as neonatal sepsis for this study. Also, a quality of care assessment in four sampled districts to measure adherence to the safe motherhood protocol will be conducted. Stata software package.55 and MLwiN software version 2.2456 will be employed in data analysis. Descriptive analysis will be carried out to explore baseline characteristics of study groups while logistic regression will be applied to evaluate the effect of the intervention. A two-tailed statistical significant level of 0.05 will be used.

Expected outcome We hypothesize that the intervention will improve both maternal and neonatal service delivery and health outcomes in the intervention areas.


Options:
A: Inclusion Criteria: those who

* are aged more than 18 years old;
* have a history of stroke (including ischemic and hemorrhagic stroke) diagnosed at county hospital or higher-level facilities, and currently in a clinically stable condition and not receiving acute stroke treatment;
* will live in this village for at least nine months during the next 12 months;
* have a basic communication ability (i.e. can understand simple instructions);
* give participant informed consent and are willing to participate in the study.

Exclusion Criteria: those who

* are unable to get out of bed without maximum assistance;
* have serious life-threatening disease such as cancers;
* who have an expected life span of less than 6 months.
B: Inclusion Criteria:

* prescriber at the study facility

Exclusion Criteria:

* not a prescriber at the study facility
C: Inclusion Criteria:

* Age ≥2 months and \<60 months of age
* Written informed consent from the child's parent or caregiver
* Axillary temperature ≥37.5°C and/or tympanic temperature ≥38.0°C
* History of fever for ≤7 days
* First consultation for the current illness
* Live in the catchment area of the health facility

Exclusion Criteria:

* Age 60 months or greater
* Age less than 2 months
* Weight less than 2.5kg
* Chief health problem is an injury, trauma or acute poisoning
D: Inclusion Criteria:

* District location in the Eastern region of Ghana.
* The districts should have an expected deliveries of ≥ 1,100 / year
* The District Health Management Team and the District Hospital Management Team must agree to participate in the study.

Exclusion Criteria:

* District location outside the Eastern region.
* The districts expected deliveries of \<1,100 / year
* The District Health Management Team and the District Hospital Management Team disagreeing to participate in the study.

Answer: D