Postpartum Empowerment: an Integrated Approach Driving Demand and Delivery of High Quality, Low-cost Postnatal Services in Kenya

NCT02104635 | Completed

• 1 other identifier: Saving Lives at Birth
• Study Type: interventional
• Target: 109
• Locations: 1 country
• Sites: 1

Brief Summary

This research represents a randomized trial of a program to improve timely postnatal care, comparing post-natal check-ups performed by community health workers delivered either by phone or in person to a control group. The study hypothesis is that when community health workers check on women three days after their delivery we will see improvements in the detection of maternal and child complications, better knowledge of complications and an increase in behaviors that are expected to lead to improved maternal and child health.

Conditions

Maternal and Newborn Health

Outcome Measures

Primary Outcomes (5)

• Complications detected

  Any maternal complications detected Number of maternal complications detected Any newborn complications detected Number of newborn complications detected

  3 days after delivery

• Successful referrals

  If CHW made referral on day 3 for baby, respondent went to health facility If CHW made referral on day 3 for mother, respondent went to health facility

  10 days after delivery (survey and administrative records)

• Care Seeking Behavior around complications and well baby check-up

  Brought baby to health facility for a well-baby check up If maternal complications (self-reported) in past week, visited or called health facility If baby complications (self-reported) in past week, visited or called health facility

  10 days after delivery (survey)

• Knowledge of danger signs

  Can name any maternal danger signs for which care should be sought (at day 10) Number of maternal danger signs named for which care should be sought (at day 10). Note: if mother lists "other" danger signs not coded, these should be coded as appropriate danger signs for which care should be sought or not Can name any baby danger signs for which care should be sought (at day 10) Number of baby danger signs named for which care should be sought (at day 10). Note: if mother lists "other" danger signs not coded, these should be coded as appropriate danger signs for which care should be sought or not

  10 days after delivery (survey)

• Breastfeeding

  Fed only breastmilk in past week

  10 days and 9 weeks after delivery (survey)

Secondary Outcomes (5)

• Referrals

  3 days after delivery (from admin records)

• Feeding behavior

  10 days 9 week after delivery (survey)

• Care seeking regarding breastfeeding, vaccines and child wellness

  10 days and 9 weeks after delivery (survey)

• Knowledge of feeding and safety

  10 days after delivery (survey)

• Care seeking at Jacaranda Health

  10 days after delivery (survey)

Study Arms (3)

Control group

NO INTERVENTION

The control group receives standard of care from Jacaranda clinic and does not receive any additional post-partum check-in from a community health worker.

CHW-Visit

EXPERIMENTAL

The CHW-Visit group will receive a visit at their home from a community health worker (CHW) three days after delivery. The CHW will administer a checklist designed to identify maternal and newborn complications and will provide information about positive maternal health and care behaviors. The CHW will encourage women to return to the clinic at 7 days to receive a well-baby check.

Behavioral: Delivery of a Post-Partum Package

CHW-Phone

EXPERIMENTAL

The CHW-Visit group will receive a phone call from a community health worker (CHW) three days after delivery. The CHW will administer a checklist designed to identify maternal and newborn complications and will provide information about positive maternal health and care behaviors. The CHW will encourage women to return to the clinic at 7 days to receive a well-baby check.

Behavioral: Delivery of a Post-Partum Package

Interventions

Delivery of a Post-Partum Package BEHAVIORAL

CHW-Phone; CHW-Visit

Eligibility Criteria

• Age: 18 Years - 40 Years
• Sex: female
• Age Groups: Adult (18-64)

You may not qualify if:

• Women who elect to leave the Jacaranda Health facility before the recommended 24 hours, against medical advice, postpartum are not eligible to participate in the postpartum care study. Women and their newborns who are referred to another hospital for higher level emergency obstetric or neonatal care will not be eligible to participate. Women who relocate outside the defined geographic area surrounding the hospital after their delivery are also not eligible.

Sponsors & Collaborators

• Harvard School of Public Health (HSPH): lead
• Jessica Cohen, Harvard School of Public Health: collaborator
• Saving Lives at Birth Initiative: collaborator
• Jacaranda Health: collaborator

Study Sites (1)

Jacaranda Health

Nairobi, Kenya

Location

Related Publications (1)

• McConnell M, Ettenger A, Rothschild CW, Muigai F, Cohen J. Can a community health worker administered postnatal checklist increase health-seeking behaviors and knowledge?: evidence from a randomized trial with a private maternity facility in Kiambu County, Kenya. BMC Pregnancy Childbirth. 2016 Jun 4;16(1):136. doi: 10.1186/s12884-016-0914-z.

  PMID: 27260500 DERIVED

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Purpose: BASIC SCIENCE
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor of Global Health Economics

Study Record Dates

• First Submitted: April 2, 2014
• First Posted: April 4, 2014
• Study Start: April 1, 2014
• Primary Completion: October 1, 2014
• Study Completion: October 1, 2014
• Last Updated: December 2, 2014

Record last verified: 2014-12

Locations

KE (1)