Please select the arm or intervention descriptions that belong 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: Arm Label: SINEMA intervention group; Type: EXPERIMENTAL; Interventions: Behavioral: SINEMA intervention | Arm Label: Control group; Type: NO_INTERVENTION; Interventions: N/A | Intervention Type: BEHAVIORAL; Name: SINEMA intervention; Assigned to Arm(s): SINEMA intervention group
B: Arm Label: A - coded unit ID; Type: EXPERIMENTAL; Interventions: Other: clinical decision support | Arm Label: B - coded unit ID; Type: NO_INTERVENTION; Interventions: N/A | Intervention Type: OTHER; Name: clinical decision support; Assigned to Arm(s): A - coded unit ID
C: Arm Label: e-POCT; Type: EXPERIMENTAL; Interventions: Other: Management of febrile children using e-POCT | Arm Label: ALMANACH; Type: ACTIVE_COMPARATOR; Interventions: Other: Management of febrile children using ALMANACH | Arm Label: Routine practice; Type: NO_INTERVENTION; Interventions: N/A | Intervention Type: OTHER; Name: Management of febrile children using e-POCT; Assigned to Arm(s): e-POCT | Intervention Type: OTHER; Name: Management of febrile children using ALMANACH; Assigned to Arm(s): ALMANACH
D: Arm Label: Intervention districts; Type: EXPERIMENTAL; Interventions: Other: Maternal and neonatal emergency protocols | Arm Label: Control districts; Type: NO_INTERVENTION; Interventions: N/A | Intervention Type: OTHER; Name: Maternal and neonatal emergency protocols; Assigned to Arm(s): Intervention districts

Answer: D