Saving Lives at Birth in Uganda: Building and Sustaining Capacity of Frontline Health Workers - A Program Evaluation
1 other identifier
interventional
3,440
0 countries
N/A
Brief Summary
The study aims are to evaluate the impact of supportive follow-up strategies for a novel twinned training and capacity-sustaining program among frontline health workers (providers) attending facility-based births in remote and district level health facilities in Uganda. The program is designed to improve provider competencies, provider performance and health outcomes among women giving birth and newborns.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Nov 2014
Typical duration for not_applicable
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
November 14, 2014
CompletedPrimary Completion
Last participant's last visit for primary outcome
December 31, 2016
CompletedStudy Completion
Last participant's last visit for all outcomes
December 31, 2016
CompletedFirst Submitted
Initial submission to the registry
July 20, 2017
CompletedFirst Posted
Study publicly available on registry
August 18, 2017
CompletedAugust 22, 2017
August 1, 2017
2.1 years
July 20, 2017
August 18, 2017
Conditions
Outcome Measures
Primary Outcomes (1)
Difference in differences: change in use of oxytocin for prevention of postpartum hemorrhage
The change in the percentage of women who received oxytocin in correct dose immediately after vaginal birth in three study arms, as assessed by direct clinical observation, using a standardized checklist.
Baseline, Midline (6 months), Endline (12 months)
Secondary Outcomes (3)
Change in provider performance on simulator-based assessments
Pre-test (before training)- post-test (immediately after training) - midline (6 months)
Difference in differences: change in care of the mother composite score
Baseline (before training), Midline (6 months), Endline (12 months)
Difference in differences: change care of the newborn composite score
Baseline (before training), Midline (6 months), Endline (12 months)
Study Arms (3)
Full - Train/oxy&miso/ B&M/Mentor/Phone
EXPERIMENTALHelping Mothers Survive- Bleeding After Birth training and Helping Babies Breathe training done at the facility, simulator present in each facility, oxytocin and misoprostol backfill, newborn bag and mask, designation of Clinical Mentor in each facility to support deliberate practice, phone-based support from district trainer for Clinical Mentor.
Partial - Train/oxy & miso/ B&M/Mentor
EXPERIMENTALHelping Mothers Survive - Bleeding After Birth training and Helping Babies Breathe training done at the facility, simulator present in each facility, oxytocin and misoprostol backfill, newborn bag and mask, designation of clinical mentor in each facility to support deliberate practice.
Comparison - Train/oxy & miso/ B&M
ACTIVE COMPARATORHelping Mothers Survive - Bleeding After Birth training and Helping Babies Breathe training done at the facility, simulator present in each facility, oxytocin and misoprostol backfill, newborn bag and mask,.
Interventions
One-day training in postpartum hemorrhage prevention and treatment; this includes instruction to provide oxytocin within one minute of birth to prevent postpartum hemorrhage.
One-day training in neonatal asphyxia management; this includes routine care for the newborn, such as drying and stimulation immediately after birth, and resuscitation of asphyxiated newborns using a bag \& mask device.
A birth attendant in the facility is designated as a clinical mentor and encouraged to lead simulator-based practice sessions in the facility after training day.
District trainers telephone clinical mentors and encourage them to lead practice sessions.
This study did not provide uterotonic drugs except in the case of stock out where locally purchased oxytocin and misoprostol were provided only as back up.
All facilities were supplied with at least 1 bag and mask for newborn resuscitation. This bag and mask was used for training, practice, and clinical care
Eligibility Criteria
You may qualify if:
- For Providers: Health providers who attend births in participating health facility and consent to be assessed at the time of enrollment and at several points in time over two years.
- For Clinical mentors: being an experienced skilled birth attendant and likely to remain at the facility during the study period
- For Women in Labor and Delivery and Newborns: Women in any stage of labor in participating facility who consent to observation of their delivery and care of their newborn (or consent from the next of kin if the woman is incapacitated and not able to provide consent)
- Facility In-charges and Stakeholders: Facility in-charges at sampled health facilities; stakeholders identified by Jhpiego senior managers as being influential in maternal and newborn health policy decisions in Uganda.
You may not qualify if:
- Providers: has \<1 year of experience, and has plans to be transferred to another facility or leave the facility soon
- Other types of participants: none
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Related Publications (2)
Williams E, Bazant ES, Holcombe S, Atukunda I, Namugerwa RI, Britt K, Evans C. "Practice so that the skill does not disappear": mixed methods evaluation of simulator-based learning for midwives in Uganda. Hum Resour Health. 2019 Mar 29;17(1):24. doi: 10.1186/s12960-019-0350-z.
PMID: 30925890DERIVEDEvans CL, Bazant E, Atukunda I, Williams E, Niermeyer S, Hiner C, Zahn R, Namugerwa R, Mbonye A, Mohan D. Peer-assisted learning after onsite, low-dose, high-frequency training and practice on simulators to prevent and treat postpartum hemorrhage and neonatal asphyxia: A pragmatic trial in 12 districts in Uganda. PLoS One. 2018 Dec 17;13(12):e0207909. doi: 10.1371/journal.pone.0207909. eCollection 2018.
PMID: 30557350DERIVED
MeSH Terms
Conditions
Interventions
Condition Hierarchy (Ancestors)
Intervention Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Cherrie Evans, DrPH
Jhpiego
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
July 20, 2017
First Posted
August 18, 2017
Study Start
November 14, 2014
Primary Completion
December 31, 2016
Study Completion
December 31, 2016
Last Updated
August 22, 2017
Record last verified: 2017-08