Clinical trial NCT03406221: Use of Mobile Technology by Community-Based Health Workers to Promote Maternal and Child Health in Bihar, India
Official title: Use of Mobile Technology to Improve the Performance of Community-Based Health Workers in Promoting Reproductive, Maternal, Newborn and Child Health and Nutrition Behaviors in Bihar, India: A Cluster Randomized Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Health
Pregnancy
Infant
Nutrition
Child
Lead sponsor: Stanford University
Sponsor class: OTHER
Collaborators: name: Bill and Melinda Gates Foundation
First posted: 2018-01-23
Enrollment: 3112
Sex: FEMALE
Minimum age (years): 15
Maximum age (years): 65
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: This study is designed to evaluate the impact of use of mobile technology by community-based health workers on health-promoting behaviors among women related to reproductive, maternal, newborn and child health and nutrition in Bihar, India.

The intervention was funded by the Bill and Melinda Gates Foundation (BMGF) and in collaboration with CARE was implemented from 2012 to 2014. Health sub-centers in the catchment areas of four blocks (sub-districts) of the district of Saharsa were randomly assigned to treatment or control arms (35 sub-centers were assigned to each). Data were collected in the Intervention and Control areas from mothers of infants 0-12 months at baseline and at 2-year follow-up, to assess the intervention's effects on quality and quantity of FLW home visits, postnatal health behaviors, and among older infants/toddlers, complementary feeding and vaccination. Difference in difference analyses were used to assess outcome effects in this quasi experimental study.

The ICT-CCS intervention was implemented in areas where the BMGF-funded Ananya program (official title: Bihar Family Health Initiative) was also being implemented. Thus, the impact is of the \[ICT-CCS intervention + Ananya\] versus \[Ananya alone\]. The Ananya program was developed and implemented via a partnership of BMGF, CARE, and the Government of Bihar. The ultimate purpose of Ananya was to reduce maternal, newborn, and child mortality; fertility; and child undernutrition in Bihar, India. Ananya involved multi-level interventions designed to build front line health worker (FLW) capacities and reach to communities and households, as well as to strengthen public health facilities and quality of care to improve maternal and neonatal care and health behaviors, and thus survival. It was implemented from 2012 to 2014. Eight focal districts in western and central Bihar received Ananya, while 30 districts did not.


Eligibility criteria: Inclusion Criteria:

* Mothers of infants 0-12 months residing in the catchment area of the subcenters

Exclusion Criteria:

-

Primary outcomes:
measure: Receipt of two or more home visits from an FLW in the final trimester of pregnancy and delivery at a facility (versus home birth), using maternal survey response
timeFrame: 2 year follow-up
measure: Receipt of any postnatal home visits from an FLW (in the first 24 hours at home after delivery and in first month following delivery), using maternal survey response
timeFrame: 2 year follow-up
measure: Any complementary feeding of solid or semisolid food for infants aged 6-11 months, using maternal survey response
timeFrame: 2 year follow-up
measure: Immunizations
timeFrame: 2 year follow-up
measure: Receipt of iron-folic acid tablets by month 4 and consumption of at least 90 tablets, using maternal survey response
timeFrame: 2 year follow-up
measure: Clean Cord Care
timeFrame: 2 year follow-up
measure: Kangaroo Mother Care (skin to skin care)
timeFrame: 2 year follow-up
measure: Delayed Bath
timeFrame: 2 year follow-up
measure: Initiation of Breastfeeding
timeFrame: 2 year follow-up
measure: Nothing applied to cord or umbilicus
timeFrame: 2 year follow-up
measure: Health worker placed child unclothed on mother's chest/abdomen in skin-to-skin contact
timeFrame: 2 year follow-up
measure: First bath delayed by two or more days
timeFrame: 2 year follow-up
measure: Breastfed child within one hour of birth
timeFrame: 2 year follow-up
Secondary outcomes:
Other outcomes:
Locations:
Study officials:
References:
citation: Carmichael SL, Mehta K, Raheel H, Srikantiah S, Chaudhuri I, Trehan S, Mohanty S, Borkum E, Mahapatra T, Weng Y, Kaimal R, Sivasankaran A, Sridharan S, Rotz D, Tarigopula UK, Bhattacharya D, Atmavilas Y, Munar W, Rangarajan A, Darmstadt GL; Ananya Study Group. Effects of team-based goals and non-monetary incentives on front-line health worker performance and maternal health behaviours: a cluster randomised controlled trial in Bihar, India. BMJ Glob Health. 2019 Aug 26;4(4):e001146. doi: 10.1136/bmjgh-2018-001146. eCollection 2019.