Please select the eligibility criteria that correspond to the clinical trial below.
Title: Assessing the Impact of Mobile Phone Technology to Improve Health Nutrition and Population (HNP) Service Utilization in Rural Bangladesh Through Pilot Intervention
Brief Summary: 1. Burden:

   In global perspective, it is estimated that the lives of 150,000 women could be saved each year worldwide with access to sufficient family planning services. It is indicated that only 26 percent women received four or more antenatal care (ANC) visits during their pregnancies, while 67.7 percent received at least one ANC during their pregnancies which are the great challenges for ensuring safe motherhood in the country. As a part of safe motherhood, it is estimated that only 28.8 percent deliveries are being conducted in health facilities in the country. In case of postnatal care (PNC), from 2008 to 2010, only 27 percent of women received PNC for their last deliveries from a medically-trained provider within two days of their delivery. Despite the tremendous success of expanded programme on immunization (EPI) in Bangladesh, a substantial number of children are not fully vaccinated under EPI as data shows 82 percent were fully vaccinated by the age of 12 months.
2. Knowledge gap:

   Use of technology for covering all or major components of primary health care (PHC) is yet to be developed and tested in Bangladesh. Further, no such initiative has yet been taken focusing community clinic (CC) to ensure equity of services in Bangladesh.
3. Relevance:

At present in Bangladesh, the CCs cater the services on family planning, maternal neonatal and child health (MNCH), health education for the rural people by using e-health strategy as the community health care provider (CHCP), newly recruited staff of community clinic are equipped with internet connected laptop service. So, updated technology for updating information, follow up and referral in primary health care can be used to increase the utilization of health services.

Hypothesis (if any):

Use of smart phones by community level healthcare providers will increase utilization of reproductive health (RH) and family planning (FP), MNCH, integrated management of childhood illness (IMCI), EPI and other PHC services at rural communities in Bangladesh.

Objectives:

To develop and test a mechanism as well as assess the impact of mHealth strategy to improve RH and FP, MNCH, IMCI, EPI and other PHC services in rural communities of Bangladesh.

Methods:

The service delivery personnel who are providing the services to the community people at different levels (community clinic, union health and family welfare centre, upazila health complex) will be equipped with smart phones having the facilities for text messages, voice messages as well as internet and data capturing. Training on handling of the smart phones, data capturing and monitoring will be provided to service providers in each upazila. They will be trained to input, edit, verify and monitor the data on different services through the software installed in their smart phones. The community clinic management and support groups will be oriented and motivated on mobile phone based registration, notification and referral to the health facilities.

Outcome measures/variables:

This will be a quasi-experimental pre-post design study and evaluation will be done through comparing antenatal care (ANC), postnatal care (PNC), and contraceptive prevalence rate (CPR) and EPI coverage before and after its implementation in the study versus comparison areas. The study will be conducted over a period of 30 months.


Options:
A: Inclusion Criteria:

1. Mother of infant aged 0-4 weeks during the study period
2. Current resident of one of the study villages
3. Willing to sign informed consent for the study

Exclusion Criteria:

1. Plans to move out of the study area in the next 6 months
2. Resides in a village with active immunization intervention/program
3. Has already received immunizations other than birth dose of BCG or polio
B: Inclusion Criteria:

* Parenting adult of child age 6 months through 8 years
* Child receives care at study site (visit in last 12 mths)
* child received influenza vaccine and needs a second this season
* Parent has cell phone has text message capability
* Parent speak English or Spanish
* Can read text messages

Exclusion Criteria:

* Parent does not speak English or Spanish
* Parent does not have cell phone with text messages
C: Inclusion Criteria:

* Currently married women of reproductive age not currently pregnant and did not have delivery within last 6 months
* Mothers of children aged 12-23 months for assessing children's vaccination coverage, and
* Mothers of children aged 0-11 months for assessing ANC, delivery care, PNC and vaccination coverage
* The service providers
D: Inclusion Criteria:

* Female;
* Age 19-26;
* Fluent in English;
* Seeking services for anything except pregnancy or abortion on the day of the visit
* No previous vaccinations for HPV
* No contraindication for HPV vaccine (includes a severe allergic reaction to yeast, amorphous aluminum hydroxyphosphate sulfate, and polysorbate 80.)
* Access to phone, text, mail, email, or facebook
* Not wanting to become pregnant in the next 8 months;
* Not planning on moving from the area in the next 8 months
* Willing to be contacted for follow-up over the next 8 months.

Exclusion Criteria:

* Women below 19 or above 26.
* Male
* Women who have one or more of HPV vaccination.
* Women who have a contraindication for HPV vaccine.
* Women who do not have access by phone, mail, email, Twitter or Facebook for follow up.
* Women who are not fluent in English
* Pregnant women or those intending on becoming pregnant during the study period.
* Women who will be moving from the area and unable to return for follow up over the course of the study (approximately 8 months).
* Severe mental impairment and unable to give Informed Consent.

Answer: C