Clinical trial NCT01802957: Health Facility Networking for Maternal Health
Official title: Health Facility Networking for Maternal Health
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Provider Skill
Provider Confidence
Maternal Health
Referral Systems
Lead sponsor: Harvard School of Public Health (HSPH)
Sponsor class: OTHER
Collaborators: name: Bill and Melinda Gates Foundation
name: Maternal Health Task Force
name: St. Paul's Hospital Millennium Medical College, Ethiopia
name: Addis Continental Institute of Public Health
name: Institute for Clinical Effectiveness and Health Policy
First posted: 2013-03-04
Enrollment: 10787
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NA
Intervention model: SINGLE_GROUP

Brief summary: This study will introduce a multi-faceted intervention package which will be implemented in the newly developed network of St. Paul's Hospital Millennium Medical College (St. Paul) and the surrounding seven satellite health centers. The goal is to assess if this group of interventions improve the skills and confidence of providers to handle obstetric emergencies, if they streamline the referral process and if they result in improved maternal/newborn health outcomes.


Eligibility criteria: Inclusion Criteria:

Sample population for each data collection instrument:

Baseline/Endline:

Key Informant Interviews:

* St. Paul hospital: Maternal Child Health (MCH) Head, Midwife/nurse from Labor and Delivery (L\&D), Midwife/nurse from Emergency
* Health Centers: Medical Director, Head of MCH (midwife) Midwife from L\&D, Referral focal person

Health Facility Assessment:

- Manager/most senior health worker asked (one from each facility)

Provider Survey:

- All providers in the MCH at both the hospital and health center level

Chart review:

- All deliveries in all centers will be screened during the intervention phase. Data on every birth will be collected from the log books of each facility. The data collector will then find the medical record of that patient to assess the Standard of Care (SOC) during Ante-natal care (ANC)- if available from the chart, L\&D and screen for an obstetric complication. If there was a complication, the near miss data will be collected.

Telephone registration log book:

- all phone calls between HC and Hospital

Facility Checklists:

- Forms completed by Supportive Supervision Teams at quarterly visits

Standardized BEmONC training evaluation

- Will be given to every provider undergoing the training, as part of the training curriculum.

Monthly mentoring evaluations - for the six months post-training mentorship, for all providers who have undergone BEmONC training.

Supportive Supervision Gap Identification Checklists

- Collected quarterly from each of the 9 facilities

Primary outcomes:
measure: Improved provider skill levels
timeFrame: One Year
measure: Improved provider self-efficacy
timeFrame: One Year
measure: Increased use of effective interventions for obstetric emergencies
timeFrame: One Year
measure: Improved standards of care for pregnant women
timeFrame: One Year
measure: Improved Referral Systems
timeFrame: One Year
Secondary outcomes:
measure: Sustainable, continuous quality improvement cycles through supportive supervision
timeFrame: One year
Other outcomes:
Locations:
city: Addis Ketema Subcity, Woreda 4
country: Ethiopia
facility: Addis Ketema Health Center
city: Addis Ketema Subcity, Woreda 9, Addis Ababa,
country: Ethiopia
facility: Woreda 7 Health Center
city: Arada Sub City, Addis Ababa
country: Ethiopia
facility: Semen Health Center
city: Gulele Sub City, Woreda 9, Addis Ababa
country: Ethiopia
facility: Selam Health Center
city: Gulele Subcity, Addis Ababa
country: Ethiopia
facility: St. Paul Hospital Millennium Medical College
city: Gulele Subcity, Woreda 10, Addis Ababa
country: Ethiopia
facility: Shegole Health Center
city: Gulele Subcity, Woreda 7
country: Ethiopia
facility: Woreda 7 Health Center
city: Kolfe sub City, Woreda 2, Addis Ababa
country: Ethiopia
facility: Kolfe Health center
Study officials:
affiliation: Harvard School of Public Health (HSPH)
name: Ana Langer, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: Addis Continental Institute of Public Health
name: Yemane Berhane, MD, MPH, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: St. Paul's Hospital Millennium Medical College, Ethiopia
name: Delayehu Bekele, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: Institute for Clinical Effectiveness and Health Policy
name: Fernando Althabe, MD
role: STUDY_DIRECTOR
References: