Clinical trial NCT03561012: Team-Based Goals and Incentives for Community-Based Health Workers to Promote Maternal and Child Health in Bihar, India
Official title: Use of Team-Based Goals and Incentives 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: Healthy
Keywords: health
nutrition
pregnancy
infant
child
Lead sponsor: Stanford University
Sponsor class: OTHER
Collaborators: name: Bill and Melinda Gates Foundation
First posted: 2018-06-19
Enrollment: 3581
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 team-based goals and performance-based incentives for 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 implemented from 2012 to 2014. Health sub-centers in the catchment areas of five blocks (sub-districts) of the district of Bengusarai were randomly assigned to treatment or control arms (38 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 2.5-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 TBGI 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 \[TBGI intervention + Ananya\] versus \[Ananya alone\]. The Ananya program was developed and implemented via a partnership of BMGF 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 (public health facilities)

Exclusion Criteria:

-

Primary outcomes:
measure: At least 2 antenatal home visits in final trimester
timeFrame: Up to 2.5 years
measure: At least one home visit within 24 hours of delivery, among women who had a home delivery
timeFrame: 2.5 year follow-up
measure: At least one home visit within 1 week of delivery
timeFrame: 2.5 year follow-up
measure: Complementary feeding home visit for women with infant 6-11 months old
timeFrame: 2.5 year follow-up
measure: Postpartum family planning home visits
timeFrame: 2.5 year follow-up
measure: Obtained phone number for delivery (Frontline worker's (FLW) number, number for private vehicle, number for ambulance, any of the above)
timeFrame: 2.5 year follow-up
measure: Received 90 IFA tablets
timeFrame: 2.5 year follow-up
measure: Immediate breastfeeding (within 1 hour of delivery)
timeFrame: 2.5 year follow-up
measure: Nothing applied to the cord after cutting
timeFrame: 2.5 year follow-up
measure: Infant age 6-11 months old ate cereal-based meal in previous day
timeFrame: 2.5 year follow-up
measure: Current use of any modern method of contraception:
timeFrame: 2.5 year follow-up
measure: Child age 6-11 months old received DPT3 vaccination
timeFrame: 2.5 year follow-up
Secondary outcomes:
Other outcomes:
Locations:
Study officials:
References: