SURVIVAL PLUSS: Increasing Capacity for Mama-baby Survival in Post-conflict Uganda and South Sudan

Study Overview
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Brief Summary
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Universal coverage of good quality facility based care globally could prevent nearly 113,000 maternal deaths, 531,000 stillbirths and 1.3 million neonatal deaths annually by 2020. Yet, only 57% of pregnant Ugandan women choose to deliver at health facilities. This unacceptably low coverage of facility based births could explain, in part, the high maternal and perinatal mortality estimates in Uganda. While multiple studies have examined factors associated with this low utilization of health services around the time of birth, there is inadequate implementation research exploring the best systematic methods that could promote uptake and scale up of facility based births. This study will therefore examine the effect of an intervention package (peer counselling by pregnancy buddies on facility based births, mobile phone messaging promoting facility based births and provision of mama-kits) on the frequency of facility based births and perinatal mortality. The study, a cluster randomized community based intervention trial in post-conflict Northern Uganda, will provide data crucial in framing national policy regarding measures to promote the use of health facilities.

Official Title
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SURVIVAL PLUSS: Increasing Capacity for Mama-baby Survival in Post-conflict Uganda and South Sudan

Conditions
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Neonatal Death, Preterm Birth, Low Birthweight, Neonatal Hypoglycemia

Intervention / Treatment
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* Behavioral: Intervention arm: An integrated package


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Pregnant women at 28 or more weeks of gestation Residence in the selected clusters Pregnant women under 18 years of age will be included since they are considered as emancipated minors in Uganda Exclusion Criteria: Intention to move from the study area within one year Psychiatric ailments that may inhibit the informed consent process
Sexes Eligible for Study
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Female

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 |
| --- | --- |
| Experimental: Intervention arm: An integrated package<br>Pregnant women in the intervention clusters will receive an integrated package consisting of peer support for facility based births by pregnancy buddies, mama kits and mobile phone messages. These components will all aim at mitigating the three delays and increasing the proportion of facility based births. | Behavioral: Intervention arm: An integrated package<br>* See description in previous column<br>|
| No Intervention: Control arm: Standard of care<br>Pregnant women in the control clusters will continue to receive the standard of care for pregnant women according to Ugandan Ministry of Health guidelines | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Facility based birth | Delivery at a health facility | Day 1 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Neonatal death | Death within the first month of life | Day 28 | 
| Timely initiation of breastfeeding | Initiation of breastfeeding with the first hour after birth | Up-to one hour after birth | 
| Severe illness | Severe illness within the first month of life | Day 28 | 
| The percent of newborns attended by a health care pro-vider during the first 48 hours following birth | Proportion of babies seen by a health care work in the first 48 hours after birth | Up-to 48 hours after birth | 
| The percent of newborns attended by a health care pro-vider during the first 7 days following birth | Proportion of babies seen by a health care work in the first one week after birth | 1 week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Facility births