NCT01409824

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

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
36

participants targeted

Target at P25-P50 for not_applicable

Timeline
Completed

Started May 2009

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

May 1, 2009

Completed
1.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 1, 2010

Completed
11 months until next milestone

First Submitted

Initial submission to the registry

August 3, 2011

Completed
1 day until next milestone

First Posted

Study publicly available on registry

August 4, 2011

Completed
2.7 years until next milestone

Study Completion

Last participant's last visit for all outcomes

April 1, 2014

Completed
Last Updated

August 4, 2011

Status Verified

February 1, 2010

Enrollment Period

1.3 years

First QC Date

August 3, 2011

Last Update Submit

August 3, 2011

Conditions

Keywords

clinical decision support systemperformance based incentivesquality of maternal health care services

Outcome Measures

Primary Outcomes (1)

  • motivation

    This research aims to increase the motivation of the health care providers through two parallel intervention packages- implementation of Clinical decision support system and incentive packages, based on the performance.

    2 years

Secondary Outcomes (1)

  • Improved quality of health services in ANC and delivery

    2 years

Study Arms (2)

without CDSS

NO INTERVENTION

This arm includes 6 health facilities in each partner country, where the clinical decision support system will not be implemented

Other: CDSS

with CDSS

EXPERIMENTAL

This arm includes 6 health facilities in each partner country, where the clinical decision support system will be implemented, parallel to the performance based incentive package

Other: CDSS

Interventions

CDSSOTHER

Clinical Decision Support System

with CDSSwithout CDSS

Eligibility Criteria

Age12 Years - 45 Years
Sexfemale
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64)

You may qualify if:

  • the patient in the primary health care center

You may not qualify if:

  • patients outside the research regions

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University of Heidelberg

Heidelberg, 69120, Germany

RECRUITING

Related Publications (2)

  • 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.

  • 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.

Related Links

Central Study Contacts

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NON RANDOMIZED
Masking
NONE
Intervention Model
PARALLEL
Sponsor Type
OTHER

Study Record Dates

First Submitted

August 3, 2011

First Posted

August 4, 2011

Study Start

May 1, 2009

Primary Completion

September 1, 2010

Study Completion

April 1, 2014

Last Updated

August 4, 2011

Record last verified: 2010-02

Locations