Clinical trial NCT01409824: Health Care Intervention Research- Improving Pre-natal and Maternal Care
Official title: Health Care Intervention Research-Quality of Prenatal and Maternal Care: Bridging the Know-do Gap (QUALMAT)
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Antenatal Care and Delivery
Keywords: clinical decision support system
performance based incentives
quality of maternal health care services
Lead sponsor: Heidelberg University
Sponsor class: OTHER
Collaborators: name: University Ghent
name: Centre de Recherche en Sante de Nouna, Burkina Faso
name: Navrongo Health Research Centre, Ghana
name: Karolinska Institutet
name: Muhimbili University of Health and Allied Sciences
First posted: 2011-08-04
Enrollment: 36
Sex: FEMALE
Minimum age (years): 12
Maximum age (years): 45
Standard ages: CHILD
ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL

Brief summary: Besides a dramatic lack of financial and human resources in developing countries, health care is additionally endangered by quality deficiencies caused by low staff motivation. This lack of motivation leads to an insufficient translation of knowledge into optimal utilization of resources. The "know-do" gap represents a challenge that must be addressed to strengthen health services performance towards achieving the Millennium Development Goals (MDGs). This is in particular true for some sensitive sectors like pre-natal and maternal health care. General objective of this research is to improve maternal health through better pre-natal and maternal care services offered by better motivated health workers. A computer-assisted clinical decision support system (CDSS) will be developed, implemented and tested aiming at (I) quality improvement of maternal and newborn care and (II) assessment of provider's performance. Based on this tool a commonly agreed incentive scheme to increase motivation will be shaped and tested in three SSA - countries, namely Burkina, Ghana, and Tanzania.

The incentive scheme might contain both non-monetary and monetary incentives and will be designed according to the human resource policy in the three countries. The planned approach is an implementation study with control arms containing one hospital and 6 first line health facilities in each of the study districts and an equal number of facilities in the control arm. A set of indicators for measurement of changes in quality of delivered services will be identified in order to follow up the sustainability and effectiveness of the strategies after their implementation. The study findings will allow understanding the important factors of staff motivation and facilitate adequate management for improvement of maternal and neonatal health care. "Knowing is not enough, we must apply; Wanting to do, is not enough, we must do it1"

- J.W. v. Goethe


Eligibility criteria: Inclusion Criteria:

* the patient in the primary health care center

Exclusion Criteria:

* patients outside the research regions

Primary outcomes:
measure: motivation
timeFrame: 2 years
Secondary outcomes:
measure: Improved quality of health services in ANC and delivery
timeFrame: 2 years
Other outcomes:
Locations:
city: Heidelberg
country: Germany
facility: University of Heidelberg
Study officials:
References:
citation: Saronga HP, Duysburgh E, Massawe S, Dalaba MA, Wangwe P, Sukums F, Leshabari M, Blank A, Sauerborn R, Loukanova S. Cost-effectiveness of an electronic clinical decision support system for improving quality of antenatal and childbirth care in rural Tanzania: an intervention study. BMC Health Serv Res. 2017 Aug 7;17(1):537. doi: 10.1186/s12913-017-2457-z.
citation: Blank A, Prytherch H, Kaltschmidt J, Krings A, Sukums F, Mensah N, Zakane A, Loukanova S, Gustafsson LL, Sauerborn R, Haefeli WE. "Quality of prenatal and maternal care: bridging the know-do gap" (QUALMAT study): an electronic clinical decision support system for rural Sub-Saharan Africa. BMC Med Inform Decis Mak. 2013 Apr 10;13:44. doi: 10.1186/1472-6947-13-44.