Incentives for Postnatal Care Demand

Study Overview
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Brief Summary
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The purpose of this study is to identify the causal impact of performance-based monetary incentives in increasing postnatal care (PNC) referrals by traditional birth attendants (TBAs), via a randomized controlled trial (RCT).

Official Title
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Incentives for Postnatal Care Demand

Conditions
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Maternal Death, Neonatal Death

Intervention / Treatment
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* Behavioral: Performance-based monetary incentives


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: community-based providers of antenatal and/or delivery care, and who are non-formally trained must be resident within the community must not plan to relocate over the intervention duration identified in partnership with community leadership be willing to participate fully in the study, including having their clients contacted for verification Exclusion Criteria: plan to relocate over the intervention duration refusal to provide informed consent for the entire study protocol including agreeing to have their delivery clients contacted for verification

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Control arm<br>Traditional birth attendants will receive an offer of two-weekly payouts per reported delivery they take that is verified by client. | |
| Experimental: Referral incentive arm<br>Traditional birth attendants will receive an offer of two-weekly payouts per reported delivery they take that is verified by client. Traditional birth attendants randomized to this arm will also receive an offer of two-weekly payouts per successful referral of delivery clients to postnatal care within 48 hours of delivery in a facility if verified. | Behavioral: Performance-based monetary incentives<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Maternal Postnatal Care Referral | The proportion of delivery clients that are successfully referred by the traditional birth attendant for postnatal care within 48 hours of delivery. For each delivery client that the traditional birth attendant reported, we visited at least three days after delivery to ascertain if they had been asked to visit the postnatal clinic, clarify if they had visited the clinic within 48 hours of delivery, and what care they had received (if yes). The team visited traditional birth attendants every two weeks to identify new clients. Where a new client was not up to three days post-delivery, the interview was postponed until the next visit by the team to the community. This occurred repeatedly, over a five-month frame. | Within 48 hours of delivery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Neonatal Postnatal Care Referral | Proportion of neonates delivered by the traditional birth attendant that are successfully referred for postnatal care within 48 hours of delivery | Within 48 hours of delivery |