Incentives for Postnatal Care Demand

NCT02936869 | Completed Results

• 1 other identifier: HU-052
• Study Type: interventional
• Target: 207
• Locations: 0 countries
• Sites: N/A

Brief Summary

The purpose of this study is to identify the causal impact of performance-based monetary incentives in increasing postnatal care (PNC) referrals by traditional birth attendants (TBAs), via a randomized controlled trial (RCT).

Conditions

Maternal Death; Neonatal Death

Outcome Measures

Primary Outcomes (1)

• Maternal Postnatal Care Referral

  The proportion of delivery clients that are successfully referred by the traditional birth attendant for postnatal care within 48 hours of delivery. For each delivery client that the traditional birth attendant reported, we visited at least three days after delivery to ascertain if they had been asked to visit the postnatal clinic, clarify if they had visited the clinic within 48 hours of delivery, and what care they had received (if yes). The team visited traditional birth attendants every two weeks to identify new clients. Where a new client was not up to three days post-delivery, the interview was postponed until the next visit by the team to the community. This occurred repeatedly, over a five-month frame.

  Within 48 hours of delivery

Secondary Outcomes (1)

• Neonatal Postnatal Care Referral

  Within 48 hours of delivery

Study Arms (2)

Control arm

NO INTERVENTION

Traditional birth attendants will receive an offer of two-weekly payouts per reported delivery they take that is verified by client.

Referral incentive arm

EXPERIMENTAL

Traditional birth attendants will receive an offer of two-weekly payouts per reported delivery they take that is verified by client. Traditional birth attendants randomized to this arm will also receive an offer of two-weekly payouts per successful referral of delivery clients to postnatal care within 48 hours of delivery in a facility if verified.

Behavioral: Performance-based monetary incentives

Interventions

Performance-based monetary incentives BEHAVIORAL

Referral incentive arm

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• community-based providers of antenatal and/or delivery care, and who are non-formally trained
• must be resident within the community
• must not plan to relocate over the intervention duration
• identified in partnership with community leadership
• be willing to participate fully in the study, including having their clients contacted for verification

You may not qualify if:

• plan to relocate over the intervention duration
• refusal to provide informed consent for the entire study protocol including agreeing to have their delivery clients contacted for verification

Sponsors & Collaborators

• Harvard School of Public Health (HSPH): lead

Related Publications (5)

• Itina SM. Characteristics of traditional birth attendants and their beliefs and practices in the Offot Clan, Nigeria. Bull World Health Organ. 1997;75(6):563-7.

  PMID: 9509629 BACKGROUND

• Sibley LM, Sipe TA, Barry D. Traditional birth attendant training for improving health behaviours and pregnancy outcomes. Cochrane Database Syst Rev. 2012 Aug 15;2012(8):CD005460. doi: 10.1002/14651858.CD005460.pub3.

  PMID: 22895949 BACKGROUND

• Oyebola, B. C., Muhammad, F., Otunomeruke, A., & Galadima, A. (2014). Effect of Performance-Based Incentives for Traditional Birth Attendants on Access to Maternal and Newborn Health-care Facilities in Gombe State, Nigeria: A Pilot Study. Meeting Abstract. Lancet.

  BACKGROUND

• WHO. (2004). Making Pregnancy Safer: The Critical Role of the Skilled Attendant - A Joint Statement by WHO, ICM, and FIGO. Geneva: World Health Organization.

  BACKGROUND

• Chukwuma A, Mbachu C, McConnell M, Bossert TJ, Cohen J. The impact of monetary incentives on referrals by traditional birth attendants for postnatal care in Nigeria. BMC Pregnancy Childbirth. 2019 May 20;19(1):150. doi: 10.1186/s12884-019-2313-8.

  PMID: 31104629 DERIVED

MeSH Terms

Conditions

Maternal Death; Perinatal Death

Condition Hierarchy (Ancestors)

Parental Death; Death; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pregnancy Complications; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases

Limitations and Caveats

This study was concluded prior to schedule due to community conflict affecting the length of follow-up time; we relied on self-reports due to the poor information systems within the study context.

Results Point of Contact

• Title: Dr. Adanna Chukwuma
• Organization: World Bank

adc785@mail.harvard.edu

9173712931

Study Officials

• Adanna Chukwuma, MBBS, MSc.

  Harvard School of Public Health (HSPH)

  PRINCIPAL INVESTIGATOR

• Margaret McConnell, PhD

  Harvard School of Public Health (HSPH)

  PRINCIPAL INVESTIGATOR

• Jessica Cohen, PhD

  Harvard School of Public Health (HSPH)

  PRINCIPAL INVESTIGATOR

• Chinyere Mbachu, MBBS, MPH

  Health Policy Research Group

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Doctoral Candidate

Study Record Dates

• First Submitted: October 14, 2016
• First Posted: October 18, 2016
• Study Start: August 1, 2016
• Primary Completion: December 1, 2016
• Study Completion: December 1, 2016
• Last Updated: July 24, 2019
• Results First Posted: July 24, 2019

Record last verified: 2019-07

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, ANALYTIC CODE
• Time Frame: The data on the Harvard Dataverse are available indefinitely as long as the website continues to host datasets.
• Access Criteria: The data can be freely downloaded without permission.