Maternal Health Clinical Trial
Official title:
Structural Hinders to and Promoters of Good Maternal Care in Rural China
This project aims to strengthen and improve the performance of health care system in rural
China in order to improve maternal and child health. It also provides policy-makers and
health service managers with evidence for the development of informed policy on maternal and
child health (MCH). The research focuses on women of reproductive age in rural areas of
China as well as on their antenatal and obstetric care service providers, both clinicians
and policy makers. For the Member States and China, as well as other countries it will
provide a comprehensive analysis and synthesis of current state of affairs, provider and
user perspectives, of antenatal and obstetric care in rural China at national and local
level. This study seeks to assess whether improving financial accessibility to and quality
of maternal health care increase use of and impact of maternity services. This project is
implemented in 3 provinces: Anhui, Shaan'xi and Chongqing. This project will provide a
practical example and information on impact of abolishing user fees on MCH service
utilisation and develop and disseminate evidence-based policy recommendations on how to
improve access to and quality of antenatal and obstetrical care for local and central
government and international organisations, and thus serve as a step toward reaching such
important goals.
CHIMACA includes 3 types of interventions, two behavioural interventions and financial
intervention. Behavioural interventions are training for clinical skills and training health
education.
Province of Chongqing:
Basic design: randomized townships (3 groups) comparing 2 different interventions to one
randomised internal control group and one non-randomized external control group. In
service-training:
1. in service-training of clinical skills: Yes. In non-randomized setting, comparing
in-service training to the external control group without training, and in randomized
setting comparing in-service training to the internal control group without in-service
training.
2. in service-training of health education: Yes. In non-randomized setting, comparing
in-service training to the external control group without training, and in randomized
setting comparing in-service training to the internal control group without in-service
training.
- Control groups: one randomized internal control group and one external
non-randomised control group.
- 20 townships in Rongchang County are divided into 2 intervention groups and one
internal control group (7 clusters)
- 6 townships in Tongliang County are randomly selected for an external control
group
Province of Shaan'xi:
Basic design: Randomized townships, 5 groups (in two counties) comparing 2 different
interventions to the randomized control group (Figure 2)
- Financial intervention: Yes. In randomized setting, comparing coverage of ante- and
postnatal care to in service-training of clinical skills, in non-randomized setting
comparing coverage of ante- and postnatal care to normal local coverage system (control
group of matched pairs).
- In service-training:
1. Clinical skills: Yes. In randomized setting, comparing in service-training of
clinical skills to coverage of ante- and postnatal care, in non-randomized setting
comparing in service-training of clinical skills to normal local coverage system
(control group of matched pairs).
2. Health education: Yes. In randomized setting, comparing in service training of
health education to normal local system, control group (in one county) and to
group of clinical skills and control group (in one county).
- Control group: randomized townships. - 25 townships in Zhen'an County are divided into
2 groups (12 clusters): one intervention and one control group
- 29 townships in Lantian County are divided into three groups (10 clusters): two
intervention groups and one control group.
Province of Anhui Basic design: randomized townships, 3 groups (in two counties), comparing
4 different interventions to randomized control groups (Figure 3)
- Financial intervention: Yes, in a randomized setting, comparing coverage of antenatal
and postnatal care to the control and in-service training groups.
- In service-training of clinical skills: Yes, in a randomized setting, comparing the
in-service training group to the control group and to the group of antenatal and
postnatal care.
- In service-training of health education: Yes, in a randomized setting, comparing two
different types of health education to the control group.
- Control groups: randomized townships
- 18 townships in Fanchang county are divided into 2 intervention groups (Group 1 and
Group 2) and one control group (Group 3)
- 12 townships in Xuancheng county are divided into two intervention groups (Group 4 and
Group 5) and one control group (Group 6).
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Health Services Research
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