Impact of a Smartphone Intervention on Tanzanian Women's Childbirth Location

NCT03161184 | Completed

• 1 other identifier: 28832
• Study Type: interventional
• Target: 572
• Locations: 0 countries
• Sites: N/A

Brief Summary

This study investigates whether training Community Health Workers (CHW) to use a smartphone-based prenatal counseling application as a "job aid" instead of the existing paper based standard is associated with increased women's use of maternal health services in Singida region, Tanzania.

Conditions

Maternal Death Affecting Fetus or Newborn; Delivery Complication; Obstetric Complication; Birth Injuries; Delivery; Injury, Maternal; Delivery Problem for Fetus

Keywords

maternal health; community health; health services; Tanzania; evaluation; cluster randomized trial

Outcome Measures

Primary Outcomes (2)

• Delivery in a facility

  Participant delivered at or on the way to a health facility, measured by retrospective report at time of interview, after delivery

  Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months)

• Antenatal care attendance

  Whether participant attended 4 ANC visits or more during their most recent pregnancy

  Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months)

Secondary Outcomes (15)

• Gestational age at first contact/ANC

  Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months)

• Iron supplementation during pregnancy

  Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months)

• HIV screening HIV Screening

  Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months)

• De-worming treatment during pregnancy

  Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months)

• Bednet use

  Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months)

Study Arms (2)

Control (paper based)

ACTIVE COMPARATOR

Women received prenatal household visits from CHWs who were trained on the Tanzania Ministry of Health and Social Welfare's National integrated Maternal, Newborn and Child Health (i-MNCH) paper-based protocols, i.e. received intervention "SUSTAIN Paperbased training of CHW (SOC)"

Behavioral: SUSTAIN Paperbased training of CHW (SOC)

Intervention (Smart phone assisted)

EXPERIMENTAL

Women received prenatal household visits from CHWs trained on the following: A) National i-MNCH programme; and B) Smartphone-assisted counseling protocol: a smartphone application designed to assist with identification of danger signs during pregnancy, referral to health facilities, and MNCH counseling , i.e. received intervention "SUSTAIN Smartphone training of CHW (SP+)"

Behavioral: SUSTAIN Smartphone training of CHW (SP+); Behavioral: SUSTAIN Paperbased training of CHW (SOC)

Interventions

SUSTAIN Smartphone training of CHW (SP+) BEHAVIORAL

Intervention (Smart phone assisted): During prenatal household visits, the smart phone based application guides CHW through electronic "decision tree" protocols, directing them to specific health/nutrition counseling topics and messages based on each woman's gestational age, and her answers to a specific series of diagnostic questions. Based on the client's gestational age, the tool directs CHW to lessons in an accompanying photo book, and reminds them to counsel on the importance of accessing timed and targeted maternal health services at health facilities. The application also assists CHW to identify danger signs during pregnancy, flags clients who require immediate referral to health facilities, and reminds CHW to follow-up with clients who were previously referred to clinics.

Intervention (Smart phone assisted)

SUSTAIN Paperbased training of CHW (SOC) BEHAVIORAL

SUSTAIN Paperbased training of CHW (SOC): During prenatal household visits, the CHW asks a specific series of diagnostic questions based on the client's gestational age, offers counsel on the importance of accessing appropriate maternal health services at health facilities and uses lessons in an accompanying photo book to deliver messages on a variety of maternal and newborn health and nutrition topics. CHW are trained to identify danger signs during pregnancy, flag clients who require immediate referral to health facilities, and follow-up with clients who were previously referred to clinics.

Control (paper based); Intervention (Smart phone assisted)

Eligibility Criteria

• Age: 16 Years - 49 Years
• Gender Eligibility Details: Participant eligibility is based on self-representation of gender identity
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• client of one of the CHWs enrolled in the mHealth study
• visited at least once by a CHW following intervention (baseline training for CHWs) and during their most recent pregnancy
• most recent delivery was a live birth and the child is still living

You may not qualify if:

• None

Sponsors & Collaborators

• University of Toronto: lead
• World Vision: collaborator
• Muhimbili University of Health and Allied Sciences: collaborator

Related Publications (1)

• Hackett K, Lafleur C, Nyella P, Ginsburg O, Lou W, Sellen D. Impact of smartphone-assisted prenatal home visits on women's use of facility delivery: Results from a cluster-randomized trial in rural Tanzania. PLoS One. 2018 Jun 18;13(6):e0199400. doi: 10.1371/journal.pone.0199400. eCollection 2018.

  PMID: 29912954 DERIVED

MeSH Terms

Conditions

Birth Injuries; Wounds and Injuries

Condition Hierarchy (Ancestors)

Infant, Newborn, Diseases; Congenital, Hereditary, and Neonatal Diseases and Abnormalities

Study Officials

• Daniel W Sellen, PhD

  University of Toronto

  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: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Model Details: Participants assigned to one of two groups in parallel for the duration of the study

Study Record Dates

• First Submitted: May 1, 2017
• First Posted: May 19, 2017
• Study Start: July 23, 2013
• Primary Completion: June 25, 2014
• Study Completion: June 25, 2014
• Last Updated: May 19, 2017

Record last verified: 2017-05

Data Sharing

• IPD Sharing: Will not share