Clinical trial NCT01480544: Improving Maternal and Child Health in India: Evaluating Demand and Supply Side Strategies (IMATCHINE)
Official title: Improving Maternal and Child Health in India: Evaluating Demand and Supply Side Strategies
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Obstetric Labor Complications
Post-partum Hemorrhage
Sepsis
Pre-eclampsia
Neonatal Mortality
Keywords: Institutional Deliveries
Maternal Health
Infant Health
Private Medical Providers
Provider Incentives
Randomized Control Trial
Lead sponsor: Duke University
Sponsor class: OTHER
Collaborators: name: Stanford University
name: International Initiative for Impact Evaluation
name: Department for International Development, United Kingdom
name: Sambodhi Research and Communication Pvt., Ltd.
First posted: 2011-11-29
Enrollment: 14990
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: The study evaluates the impact of a new conditional cash transfer (CCT) program (Thayi Bhagya Yojana) to promote child birth in obstetric facilities in the state of Karnataka, India in order to determine its policy value and to guide efforts to improve maternal and infant health outcomes nationally. In addition, the study includes a large randomized evaluation of performance-based incentive payments to providers to improve quality of medical care provided during delivery and actual health improvement in the providers' patient populations and their catchment areas.

Detailed description: The evaluation study will first provide new evidence on the effectiveness of demand-side strategies to increase institutional deliveries and improve childbirth outcomes. Second, the study will analyze one of the first implementations of direct rewards to providers for health improvement in a developing country. Third, the study will provide critical new insight into dynamics between demand and supply-side incentives in improving population health outcomes as either complements or substitutes.

The study uses household survey to collect data from mothers on socio-economic, human capital, quality of life variables (including below poverty line \[BPL\] index components) and as well as information about deliveries, fertility histories, morbidity and mortality (for mothers, infants, and children), birth related complications, health service use and spending. Additionally, provider surveys will collect data on infrastructure, staffing, provider qualifications, provider knowledge and process measures of provider performance.

Eligibility criteria: Inclusion Criteria:

* Households with new mothers (one to three weeks after childbirth)
* Rural private sector maternity care providers who are listed on the Karnataka government's legitimate provider list.

Exclusion Criteria:

* Households without children
* Households where mothers gave birth \> 3 weeks ago
* Public sector maternity care providers
* Private sector maternity care providers serving in towns with large public providers such as Community Health Centers (CHCs)

Primary outcomes:
measure: Increase institutional deliveries and improve maternal and infant health outcomes in the population.
timeFrame: 1 Year
Secondary outcomes:
measure: Effectiveness of financial incentives to maternity care private providers for improvements in the clinical quality of services in the providers' patient populations and the catchment areas they serve.
timeFrame: 1 Year
measure: Effectiveness of financial incentives to maternity care private providers for improvements in maternal and infant health outcomes in the providers' patient populations and the catchment areas they serve.
timeFrame: 1 Year
Other outcomes:
Locations:
city: Bangalore
country: India
facility: Imatchine
state: Karnataka
Study officials:
affiliation: Duke University
name: Manoj Mohanan, PhD, MPH
role: PRINCIPAL_INVESTIGATOR
References: