Evaluating the Efficacy of Using a Digital Consumption Management Tool for Family Planning in Zambia
Condition: Family Planning
Study type: Interventional

Summary: 
      The primary objective of this evaluation is to understand the effectiveness of the OpenSRP
      platform on unmet family planning (FP) demand in rural Zambia. The specific objectives are
      to:

        1. assess the impact of the intervention on satisfaction and use of modern family planning
           methods among last-mile people of childbearing potential; and

        2. understand the impact of the intervention on FP inventory management and dispensing.

      The investigators will employ mixed-methods for data collection for this two-arm
      cluster-randomized trial. This effectiveness evaluation will be paired with a concurrent
      implementation evaluation, making it a Type 2 Hybrid Design.

      For the impact evaluation data will be collected from two main sources at both baseline and
      endline: 1) existing stock management records (eLMIS and paper records, depending on study
      arm); and 2) Short phone surveys with people of childbearing potential in the community.
    

Detailed description: 
      Rural health facilities catchment areas (HFCAs) and their affiliated CHWs (clusters) will be
      randomly assigned to the intervention or control arm. The impact evaluation will consist of a
      cross-sectional baseline assessment of a sample of women living in the catchment areas of
      both the intervention and control clusters. This will be followed by a six months of
      implementation phase (mobile device distribution to CHW, CHW training, CHW utilization of the
      Open SRP). At endline after six months, a new cross-sectional sample of respondents will be
      assessed in both the intervention and control clusters.

      To achieve objective 1, a short questionnaire will be administered over the phone to a
      cross-sectional sample of last-mile people of childbearing potential living in both the
      intervention and control clusters. The sample will be drawn from the CHW's client lists and
      use a short telephone call to reach respondents.

      To achieve objective 2, the same quantitative indicators will be abstracted from two
      different data sources, depending on the study arm: 1) OpenSRP data captured in the CHW
      tablets among the intervention sites, and 2) data extracted from the paper records maintained
      by the CHWs or the health facility or the electronic management system in the control sites
      (and at baseline).
    

Intervention name(s): Intervention package
Intervention type(s): Other
Intervention description(s): The intervention package will include a mobile device configured with OpenSRP configured to facilitate clinical/service provision and stock management. The intervention also incorporates a training component on OpenSRP with accompanying follow-up supervisory visits for a limited period. Per the theory of changes, these activities will improve CHWs' knowledge and ability to use the platform for clinical care, dispensing, and workflow management, leading to an improved stock of commodities to meet preferred FP needs among last mile women.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: The study design is a two-arm cluster-randomized trial. The unit of randomization is the health facility catchment areas (HFCAs) which will be matched in pairs on 1) ruralness as defined by distance/time to the nearest tertiary clinic or district capital; 2) supply chain performance as defined by number of family planning commodities stockouts in the nearest preceding three to six month period for which data are available (for baseline: August to October, 2022; for endline: February to June 2023); 3) catchment area size and; 4) number of CHW affiliates. This effectiveness evaluation will be paired with a concurrent implementation evaluation, making it a Type 2 Hybrid Design.
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Digital consumption management tool; Community health workers; OpenSRP; Rural Zambia