Improving Maternal and Child Health in India: Evaluating Demand and Supply Side Strategies (IMATCHINE)

NCT01480544 | Completed

• 1 other identifier: Pro00031046
• Study Type: interventional
• Target: 14,990
• Locations: 1 country
• Sites: 1

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.

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

Outcome Measures

Primary Outcomes (1)

• Increase institutional deliveries and improve maternal and infant health outcomes in the population.

  Rates of deliveries in hospitals and maternal health complications such as obstetric fistulas, post-partum hemorrhage, sepsis, as well as neonatal outcomes.

  1 Year

Secondary Outcomes (2)

• 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.

  1 Year

• 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.

  1 Year

Study Arms (4)

Mothers at endline

NO INTERVENTION

Data collected on new mothers (up to three weeks after childbirth) in 180 clusters with 100 mothers in each cluster at endline.

Treatment 1

EXPERIMENTAL

Data collected on new mothers (up to three weeks after childbirth) and on providers with incentives for clinical improvements in quality of maternity care in the providers' patient populations and the catchment areas served by the providers.

Other: Experimental: Treatment 1

Treatment 2

EXPERIMENTAL

Data collected on new mothers (up to three weeks after childbirth) and on providers with incentives for improvement in maternal and infant health outcomes in the providers' patient populations and in the catchment areas served by the providers.

Other: Experimental: Treatment 2

Control

NO INTERVENTION

Data collected on new mothers (up to three weeks after childbirth) and providers with no incentives

Interventions

Experimental: Treatment 1 OTHER

Physicians will receive financial incentives for improving the quality of obstetric and neonatal care provided to mothers and newborns as reported by mothers during household interviews.

Treatment 1

Experimental: Treatment 2 OTHER

Physicians will receive financial incentives for improving maternal and neonatal health outcomes as reported by mothers during household interviews.

Treatment 2

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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.

You may not qualify if:

• 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)

Sponsors & Collaborators

• Duke University: lead
• Stanford University: collaborator
• International Initiative for Impact Evaluation: collaborator
• Department for International Development, United Kingdom: collaborator
• Sambodhi Research and Communication Pvt., Ltd.: collaborator

Study Sites (1)

Imatchine

Bangalore, Karnataka, India

Location

MeSH Terms

Conditions

Obstetric Labor Complications; Postpartum Hemorrhage; Sepsis; Pre-Eclampsia

Condition Hierarchy (Ancestors)

Pregnancy Complications; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Puerperal Disorders; Uterine Hemorrhage; Hemorrhage; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Infections; Systemic Inflammatory Response Syndrome; Inflammation; Hypertension, Pregnancy-Induced

Study Officials

• Manoj Mohanan, PhD, MPH

  Duke University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 8, 2011
• First Posted: November 29, 2011
• Study Start: August 1, 2012
• Primary Completion: December 1, 2014
• Study Completion: November 1, 2015
• Last Updated: December 16, 2015

Record last verified: 2015-12

Locations

IN (1)