Effects of a Health Workforce Capacity Building and Quality Improvement Intervention in Kinshasa
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|ClinicalTrials.gov Identifier: NCT03363308|
Recruitment Status : Completed
First Posted : December 6, 2017
Last Update Posted : July 24, 2020
|Condition or disease||Intervention/treatment||Phase|
|Maternal Death Infant Death Stillbirth||Behavioral: training for health care workers supplmented by QI teams||Not Applicable|
The health workforce capacity building and quality improvement intervention will be implemented in two phases: eight facilities will receive the intervention in phase 1 and the remaining eight facilities will receive the intervention in phase 2.
Objective 1: For objective 2 on facility-based health outcomes, the study design is a cluster-randomized evaluation in phase 1. The intervention's effects will be assessed by comparing an intervention group and a control group of facilities. These will be selected from 16 Kinshasa health facilities. Intervention and control facilities' monthly reported health outcomes will be compared in a 12-month baseline period and 12-month period during and after the intervention implementation (Phase 1) in a difference-in-difference analysis. In Phase 2, all facilities will have their monthly service statistics and health outcomes reviewed for trends in improvement.
Overall, in Phase 1, eight intervention sites will be matched to eight sites serving as controls. In Phase 2, the eight Phase 1 control sites will then receive the same package as the intervention sites in Phase 1. Sites will be stratified by case load, low and high (over 90 births per month), and funding (public or private funding). Within each stratum, prior to start of the intervention, there will be random selection to intervention and control groups to allow for baseline comparability between groups.
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||250 participants|
|Intervention Model:||Parallel Assignment|
|Intervention Model Description:||This is a cluster-randomized trial in phase I and interrupted time series in phase II|
|Masking:||None (Open Label)|
|Official Title:||Effects of a Health Workforce Capacity Building and Quality Improvement Intervention on Intrapartum Stillbirth, Early Newborn Mortality and Post-pregnancy Family Planning in Kinshasa: a Cluster Randomized Evaluation|
|Actual Study Start Date :||November 16, 2017|
|Actual Primary Completion Date :||June 30, 2020|
|Actual Study Completion Date :||June 30, 2020|
Experimental: Phase 1
training for health care workers supplemented by QI teams
Behavioral: training for health care workers supplmented by QI teams
Jhpiego will deliver maternal and newborn health and family planning (MNH+FP) training using evidence-based low-dose, high-frequency (LDHF) learning approaches and support hospital staff-led quality improvement efforts to increase the coverage of facility-based high-impact interventions, including care of the mother and newborn on the day of birth and through the first week postpartum and post abortion services.
|No Intervention: Phase 2|
- Mean number or percent of items correctly answered [ Time Frame: 1 day ]Each observed structured clinical exam (OSCE) or knowledge tests has between 13 and 38 items. A participant needs to achieve 85% correct score to pass at post-training to assess provider competencies. The main indicator for analysis will be the mean number of items (or percent of items) correctly answered. This mean percent of items correctly answered will be done pre-training, post-training and after 6 months. This will be done in the 8 intervention group facilities only in Phase I and again in the 8 new facilities in Phase II.
- Intrapartum perinatal death ratio [ Time Frame: 1 day ]Defined as death of a fetus during labor who had heart tones documented on arrival in the maternity and neonatal deaths prior to 24 hours, divided by total births.
- Percent of women after childbirth who adopt a family planning method immediately post-pregnancy or intend to adopt a method by six weeks post-pregnancy. [ Time Frame: 3 days ]Percent of women after childbirth who adopt a family planning method over all women who give birth in a facility
- maternal mortality [ Time Frame: 3 days ]number of maternal deaths over number of live births
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): NCT03363308
|Congo, The Democratic Republic of the|
|Kinshasa, Congo, The Democratic Republic of the|
|Principal Investigator:||Virgile Kikaya||Jhpiego DRC|