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Trial record 5 of 1349 for:    rural

Assessing the Impact of Mobile Phone Technology to Improve Health Nutrition and Population (HNP) Service Utilization in Rural Bangladesh Through Pilot Intervention

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ClinicalTrials.gov Identifier: NCT03189004
Recruitment Status : Recruiting
First Posted : June 16, 2017
Last Update Posted : December 11, 2018
Sponsor:
Information provided by (Responsible Party):
International Centre for Diarrhoeal Disease Research, Bangladesh

Brief Summary:
  1. Burden:

    In global perspective, it is estimated that the lives of 150,000 women could be saved each year worldwide with access to sufficient family planning services. It is indicated that only 26 percent women received four or more antenatal care (ANC) visits during their pregnancies, while 67.7 percent received at least one ANC during their pregnancies which are the great challenges for ensuring safe motherhood in the country. As a part of safe motherhood, it is estimated that only 28.8 percent deliveries are being conducted in health facilities in the country. In case of postnatal care (PNC), from 2008 to 2010, only 27 percent of women received PNC for their last deliveries from a medically-trained provider within two days of their delivery. Despite the tremendous success of expanded programme on immunization (EPI) in Bangladesh, a substantial number of children are not fully vaccinated under EPI as data shows 82 percent were fully vaccinated by the age of 12 months.

  2. Knowledge gap:

    Use of technology for covering all or major components of primary health care (PHC) is yet to be developed and tested in Bangladesh. Further, no such initiative has yet been taken focusing community clinic (CC) to ensure equity of services in Bangladesh.

  3. Relevance:

At present in Bangladesh, the CCs cater the services on family planning, maternal neonatal and child health (MNCH), health education for the rural people by using e-health strategy as the community health care provider (CHCP), newly recruited staff of community clinic are equipped with internet connected laptop service. So, updated technology for updating information, follow up and referral in primary health care can be used to increase the utilization of health services.

Hypothesis (if any):

Use of smart phones by community level healthcare providers will increase utilization of reproductive health (RH) and family planning (FP), MNCH, integrated management of childhood illness (IMCI), EPI and other PHC services at rural communities in Bangladesh.

Objectives:

To develop and test a mechanism as well as assess the impact of mHealth strategy to improve RH and FP, MNCH, IMCI, EPI and other PHC services in rural communities of Bangladesh.

Methods:

The service delivery personnel who are providing the services to the community people at different levels (community clinic, union health and family welfare centre, upazila health complex) will be equipped with smart phones having the facilities for text messages, voice messages as well as internet and data capturing. Training on handling of the smart phones, data capturing and monitoring will be provided to service providers in each upazila. They will be trained to input, edit, verify and monitor the data on different services through the software installed in their smart phones. The community clinic management and support groups will be oriented and motivated on mobile phone based registration, notification and referral to the health facilities.

Outcome measures/variables:

This will be a quasi-experimental pre-post design study and evaluation will be done through comparing antenatal care (ANC), postnatal care (PNC), and contraceptive prevalence rate (CPR) and EPI coverage before and after its implementation in the study versus comparison areas. The study will be conducted over a period of 30 months.


Condition or disease Intervention/treatment Phase
Maternal Health Child Health Vaccination Family Planning Services Behavioral: Impact of Mobile Phone Technology to Improve Health Nutrition and Population (HNP) Service Utilization in Rural Bangladesh Not Applicable

  Show Detailed Description

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 5280 participants
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Health Services Research
Official Title: Assessing the Impact of Mobile Phone Technology to Improve Health Nutrition and Population (HNP) Service Utilization in Rural Bangladesh Through Pilot Intervention
Actual Study Start Date : April 2016
Estimated Primary Completion Date : September 2019
Estimated Study Completion Date : September 2019

Arm Intervention/treatment
Active Comparator: Identification and registration of pregnant women and servic
Pregnant women will receive auto reminder through their mobile for ANC visit prior to their scheduled date for each visit via voice message followed by text message. The schedule visit date will be calculated by the system automatically from the LMP. The reminder will include the date, time, available facilities and services for ANC, and will be sent to the women several times to ensure their ANC visits. The system will also send auto reminder through text message to the concerned service provider to check whether the pregnant woman has received ANC or not. The service provider will provide and update the ANC services and status of the particular pregnant woman. Apart from ANC reminders, the pregnant women will also receive voice message on healthcare during pregnancy, danger signs and birth preparedness.From the LMP, the expected date of delivery (EDD) will be calculated by the system and reminder will be sent to the pregnant women automatically.
Behavioral: Impact of Mobile Phone Technology to Improve Health Nutrition and Population (HNP) Service Utilization in Rural Bangladesh
  1. Identification and registration of pregnant women and services for them
  2. Birth notification
  3. Childhood vaccination services under EPI
  4. Newly married couple identification
  5. e-Referral.
  6. e-monitoring
Other Name: Assessing the Impact of Mobile Phone Technology to Improve Health Nutrition and Population (HNP) Service Utilization in Rural Bangladesh through Pilot Intervention

Active Comparator: Birth notification
The pregnant women will be encouraged and trained to notify immediately after the delivery through SMS by themselves or by anyone on behalf of the delivered women. After receiving birth notification, system will automatically update the particulars of newborns including date of birth, PNC schedule, EPI vaccination due dates for the newborn and location of service centre. The system will also send auto reminder to the mothers with a specific time schedule for PNC visit, newborn care visit and schedule of receiving vaccines for the newborn.
Behavioral: Impact of Mobile Phone Technology to Improve Health Nutrition and Population (HNP) Service Utilization in Rural Bangladesh
  1. Identification and registration of pregnant women and services for them
  2. Birth notification
  3. Childhood vaccination services under EPI
  4. Newly married couple identification
  5. e-Referral.
  6. e-monitoring
Other Name: Assessing the Impact of Mobile Phone Technology to Improve Health Nutrition and Population (HNP) Service Utilization in Rural Bangladesh through Pilot Intervention

Active Comparator: Childhood vaccination services under EPI
After the outcome of the delivery of the registered pregnant women, the system will receive the birth notification as mentioned in the birth notification process. Mothers/caregivers of the newborn will receive auto voice/text messages one day prior to their visit to the vaccination centres. A second reminder will be sent to the parents of all the targeted children through their own phones or their family's numbers collected earlier on the vaccination day at the beginning of the vaccination session for bringing their children for vaccination. A third reminder will be sent to the mothers/caregivers of the children who were not vaccinated after receiving the second reminder as scheduled on that day. The system will also provide auto reminder to the concerned service provider including EPI session wise list of targeted children. The service providers will update the status of vaccination of session using their Smartphone
Behavioral: Impact of Mobile Phone Technology to Improve Health Nutrition and Population (HNP) Service Utilization in Rural Bangladesh
  1. Identification and registration of pregnant women and services for them
  2. Birth notification
  3. Childhood vaccination services under EPI
  4. Newly married couple identification
  5. e-Referral.
  6. e-monitoring
Other Name: Assessing the Impact of Mobile Phone Technology to Improve Health Nutrition and Population (HNP) Service Utilization in Rural Bangladesh through Pilot Intervention

Active Comparator: Newly married couple identification
The Smartphones will contain specific software for newly married couple registration where some necessary information (names of newly married couple, age, address, LMP, current contraceptive use, future fertility plan and mobile phone number) can be updated and sent to the server. A unique ID number will be automatically created. This unique ID will ensure her to get necessary family planning services within the study area. Based on the information gathered through couple registration process, the system will automatically generate the most suitable family planning options for a couple and send the information to the concerned service providers. The service provider will motivate the client for the most suitable FP method option generated by the system and after taking the consent they provide the method accordingly.
Behavioral: Impact of Mobile Phone Technology to Improve Health Nutrition and Population (HNP) Service Utilization in Rural Bangladesh
  1. Identification and registration of pregnant women and services for them
  2. Birth notification
  3. Childhood vaccination services under EPI
  4. Newly married couple identification
  5. e-Referral.
  6. e-monitoring
Other Name: Assessing the Impact of Mobile Phone Technology to Improve Health Nutrition and Population (HNP) Service Utilization in Rural Bangladesh through Pilot Intervention

Active Comparator: e-Referral
There will be online referral system for the registered women and their children for ANC, PNC, delivery care, neonatal management, IMCI and other complication management in which healthcare providers from lower facilities can refer a patient to the higher facilities. The women will be identified in the higher facilities by their unique ID. The service providers will enter referral data to the system during the referral process and the patients and providers from higher facilities will get system generated reminders about the referral. The service providers in higher facilities will be able to check the health status and cause of referral using patient's unique ID number from the system and will manage accordingly as well as update the given management to the system. If the referred woman does not visit the referral facility, she will receive repeated reminders auto-generated by the system to comply the referral
Behavioral: Impact of Mobile Phone Technology to Improve Health Nutrition and Population (HNP) Service Utilization in Rural Bangladesh
  1. Identification and registration of pregnant women and services for them
  2. Birth notification
  3. Childhood vaccination services under EPI
  4. Newly married couple identification
  5. e-Referral.
  6. e-monitoring
Other Name: Assessing the Impact of Mobile Phone Technology to Improve Health Nutrition and Population (HNP) Service Utilization in Rural Bangladesh through Pilot Intervention

Active Comparator: e-monitoring
There will be web based monitoring system to oversee the progress and status of all the activities under this study for policy makers, programme peoples and other supervisors from national to the union levels. All these data will be available in the central database which will be visualized and accessible at all concerned levels through internet in particular website. They can constantly follow up the progression and healthcare delivery system of the respective area and provide regular feedback, when necessary. There will be provision of auto-generation of reports for each and every activity through the system by area and service provider specific.
Behavioral: Impact of Mobile Phone Technology to Improve Health Nutrition and Population (HNP) Service Utilization in Rural Bangladesh
  1. Identification and registration of pregnant women and services for them
  2. Birth notification
  3. Childhood vaccination services under EPI
  4. Newly married couple identification
  5. e-Referral.
  6. e-monitoring
Other Name: Assessing the Impact of Mobile Phone Technology to Improve Health Nutrition and Population (HNP) Service Utilization in Rural Bangladesh through Pilot Intervention




Primary Outcome Measures :
  1. ANC [ Time Frame: Assess the recommend number of ANC (4 ANC) coverage 18 months after intervention ]
    Number of ANC coverage before and after its implementation

  2. PNC [ Time Frame: Assess the recommend number of PNC (3 ANC) coverage 18 months after intervention ]
    Number of PNC coverage before and after its implementation

  3. Contraceptive prevalence rate (CPR) [ Time Frame: Assess the Contraceptive prevalence rate (CPR) at the end of intervention of 18 months. ]
    Assess the Contraceptive prevalence rate (CPR) coverage

  4. EPI coverage [ Time Frame: Assess the EPI vaccination coverage at the end of the intervention of 18 months ]
    EPI coverage before and after its implementation



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 45 Years   (Adult)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Currently married women of reproductive age not currently pregnant and did not have delivery within last 6 months
  • Mothers of children aged 12-23 months for assessing children's vaccination coverage, and
  • Mothers of children aged 0-11 months for assessing ANC, delivery care, PNC and vaccination coverage
  • The service providers

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03189004


Contacts
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Contact: Jasim Uddin, PhD 01730019691 jasim@icddrb.org
Contact: Tuhin Biswas, MPH tuhin.biswas@icddrb.org

Locations
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Bangladesh
Icddr,B Recruiting
Dhaka, Bangladesh
Contact: Salam Khan         
Sponsors and Collaborators
International Centre for Diarrhoeal Disease Research, Bangladesh
Investigators
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Principal Investigator: Jasim Uddin, PhD International Centre for Diarrhoeal Disease Research, Bangladesh

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Responsible Party: International Centre for Diarrhoeal Disease Research, Bangladesh
ClinicalTrials.gov Identifier: NCT03189004     History of Changes
Other Study ID Numbers: 16019
First Posted: June 16, 2017    Key Record Dates
Last Update Posted: December 11, 2018
Last Verified: August 2018

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by International Centre for Diarrhoeal Disease Research, Bangladesh:
mHealth, health services, technology, smartphones, Bangladesh
Additional relevant MeSH terms:
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Vaccines
Immunologic Factors
Physiological Effects of Drugs