Clinical trial NCT06304831: Use of Facility Ratings to Improve Satisfaction With Heath Care for Children
Official title: Facility Ratings to Improve Satisfaction With Heath Care for Children
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Quality of Health Care
Lead sponsor: Swiss Tropical & Public Health Institute
Sponsor class: OTHER
Collaborators: name: Lao Tropical and Public Health Institute
First posted: 2024-03-12
Enrollment: 559
Sex: FEMALE
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: SINGLE_GROUP
Intervention model description: This study consists of a randomized controlled experiment involving 660 mothers with children less than 2 years old. Participants will be randomly assigned to one of two groups: 1) a control group that will not receive any information about providers and 2) an intervention group that will receive biweekly updates about quality ratings based on reviews collected from mothers of young children in the study areas. The unit of randomization will be the individual participant. A simple random number draw generated by the ODK package installed on the tablets will be used to assign participants to treatment and control with equal probability.
Primary purpose: OTHER

Brief summary: Despite increasing options for public and private health care providers in Laos, choosing a high-quality health provider or a facility is difficult because timely and reliable information about providers is not readily available. People rely on social networks or previous experiences to select providers. However, in Laos, only 28% describe their recent visit to a health care provider as high-quality suggesting that while there are increasing options for care, people may need support to find providers that meet their quality needs. Rapid adoption of mobile phones in Laos, particularly in urban areas, offer opportunities to enhance people's access to timely quality information about health care providers. The study team will use mobile phones to collect and disseminate quality information about providers - known to be valued by Laotians - to improve their access to quality care as well as their overall satisfaction with care.

Detailed description: While access to health care is expanding globally, there is appreciable variation in the quality of care among providers with low-quality care accounting for up-to 5 million deaths each year. These numbers are expected to grow as more people seek care and as the burden of disease shifts to complex conditions.

Expanding access has also resulted in increasing options for public and private health care providers. Selecting a health provider or a facility, however, is difficult because timely and reliable information about providers is not readily available. People often rely on social networks or previous experiences to select providers. However, in Lao PDR, only 28% describe their recent visit to a health care provider as high-quality, suggesting that while there are increasing options for care, people may need support to find providers that meet their quality needs.

In order to inform efforts to improve people's access to high-quality care, there is a need for evidence on mechanisms to empower people to identify and use high-quality care. In LMICs, majority of efforts to date has focused on supply-side efforts. While there are new initiatives to study population perspectives and people's care experiences, measures to "ignite demand" for high-quality care are not well understood.

The investigators plan to conduct a randomized-controlled experiment using mobile-phones to study whether routinely collected information on quality of care received by peers can improve access to high-quality care and patient satisfaction. The investigators plan to study whether participants switched providers based on the information provided and the type of information mothers used to switch providers. Additionally, The investigators plan to study whether information about providers led women to be more satisfied with health care services for their child or children. Study participants will include mothers living in an urban setting with less than 2-year old children and already enrolled in an on-going VITERBI cohort in Vientiane, the capital city.

Eligibility criteria: Inclusion Criteria:

* All women 18 years of age and older and enrolled in Vientiane Multigenerational Birth Cohort (VITERBI) with at least one child less than two years old, able to read, have exclusive access to a mobile phone, have a WhatsApp account, understand and sign the ICF will be eligible to participate in the study. The eligibility criteria will be assessed using data collected from VITERBI. Ability to read will be tested using a script in Lao, "I use my mobile phone every day."

Exclusion Criteria:

* Eligible women unwilling to sign informed consent, without exclusive access to a mobile phone, unable to read the test script, or unable operate a mobile phone will be excluded from the study.

Primary outcomes:
measure: Proportion of mothers that change their preferred health care providers for children for non-urgent care
timeFrame: 3 months
Secondary outcomes:
measure: Proportion of mothers satisfied with health care for their children of their most recent visit
timeFrame: 3 months
measure: Number and type of health care providers used in the past 3 months
timeFrame: 3 months
measure: Proportion of mothers that change their most recently visited health care providers for children
timeFrame: 3 months
measure: Proportion of mothers choosing the preferred facility for non-urgent care because of online or digital information sources
timeFrame: 3 months
measure: Proportion of mothers that change their preferred health care providers for children for urgent care
timeFrame: 3 months
measure: Proportion of mothers confident they can identify the best place for getting care for sick children
timeFrame: 3 months
Other outcomes:
Locations:
city: Vientiane
country: Lao People's Democratic Republic
facility: Lao Tropical and Public Health Institute
state: Vientiane Capital
Study officials:
affiliation: Swiss Tropical & Public Health Institute
name: Günther Fink, PhD
role: STUDY_CHAIR
affiliation: Swiss Tropical & Public Health Institute
name: Amit Aryal, MPH
role: PRINCIPAL_INVESTIGATOR
References: