Clinical trial NCT03290924: Accelerating Newborn Survival in Ghana Through a Low-dose, High-frequency Health Worker Training Approach
Official title: Accelerating Newborn Survival in Ghana Through a Low-dose, High-frequency Health Worker Training Approach
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Stillbirth
Neonatal Death
Keywords: institutional delivery
Lead sponsor: Jhpiego
Sponsor class: OTHER
Collaborators: name: Bill and Melinda Gates Foundation
First posted: 2017-09-25
Enrollment: 40
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: This study assesses the effect of a low-dose, high-frequency training approach on long-term evidence-based skill retention among skilled birth attendants and impact on adverse birth outcomes at hospitals in Ghana.

Detailed description: In-service training for skilled birth attendants (SBAs) is one of the most common interventions to address lack of knowledge and skills. However, these training interventions are seldom evaluated for effectiveness in improving learning or performance.

This study study is a cluster-randomized waitlist trial implemented in 40 public and mission hospitals in Ghana. It assesses the effect of a low-dose, high-frequency (LDHF) training approach to update hospital-based SBAs in key evidence-based intrapartum and immediate newborn care practices, using current global guidelines.The LDHF approach includes two 4-day onsite sessions (low dose) with weekly practice sessions, SMS quizzes and reminders, and mentoring via mobile phone and onsite visits between trainings (high frequency). The low-dose sessions include competency acquisition through simulation, case-based learning, and small content packages spread over short time intervals.

Eligible hospitals will be stratified by geographic region and caseload, and then randomly assigned to one of four implementation waves. The pipeline randomization allows for rigorous evaluation while the program is rolled out to all facilities.

Eligibility criteria: INCLUSION CRITERIA - FACILITIES:

* Public or faith based hospital
* At least three skilled birth attendants on staff
* At least 30 births per month

EXCLUSION CRITERIA - FACILITIES:

* Private hospital
* Public or faith based hospital with less than three skilled birth attendants on staff
* Public or faith based hospital with less than 30 births per month

INCLUSION CRITERIA - SERVICE PROVIDERS:

\* Health providers who attend births in participating health facilities and consent to be assessed at the time of enrollment and at several points in time over the study period

EXCLUSION CRITERIA - SERVICE PROVIDERS:

\* Health providers who decline to participate

Primary outcomes:
measure: institutional twenty-four hour newborn mortality rate
timeFrame: 1 day
measure: institutional intrapartum stillbirth rate
timeFrame: 1 day
Secondary outcomes:
measure: skilled birth attendant knowledge and skills
timeFrame: Pre-test (before training) - post-test (immediately after training) - endline (12 months)
Other outcomes:
Locations:
Study officials:
affiliation: Senior Technical Advisor
name: Patricia Gomez
role: PRINCIPAL_INVESTIGATOR
References:
citation: Gomez PP, Nelson AR, Asiedu A, Addo E, Agbodza D, Allen C, Appiagyei M, Bannerman C, Darko P, Duodu J, Effah F, Tappis H. Accelerating newborn survival in Ghana through a low-dose, high-frequency health worker training approach: a cluster randomized trial. BMC Pregnancy Childbirth. 2018 Mar 22;18(1):72. doi: 10.1186/s12884-018-1705-5.