Use of Mobile Technology by Community-Based Health Workers to Promote Maternal and Child Health in Bihar, India

Pregnancy Clinical Trial

— ICT-CCS  

Official title:

Use of Mobile Technology to Improve the Performance of Community-Based Health Workers in Promoting Reproductive, Maternal, Newborn and Child Health and Nutrition Behaviors in Bihar, India: A Cluster Randomized Trial

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03406221
• Other study ID #: IRB-39719
• Status: Completed
• Phase: N/A
• Start date: January 1, 2012
• Est. completion date: August 31, 2014

Study information

• Verified date: April 2023
• Source: Stanford University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study is designed to evaluate the impact of use of mobile technology by community-based health workers on health-promoting behaviors among women related to reproductive, maternal, newborn and child health and nutrition in Bihar, India.

The intervention was funded by the Bill and Melinda Gates Foundation (BMGF) and in collaboration with CARE was implemented from 2012 to 2014. Health sub-centers in the catchment areas of four blocks (sub-districts) of the district of Saharsa were randomly assigned to treatment or control arms (35 sub-centers were assigned to each). Data were collected in the Intervention and Control areas from mothers of infants 0-12 months at baseline and at 2-year follow-up, to assess the intervention's effects on quality and quantity of FLW home visits, postnatal health behaviors, and among older infants/toddlers, complementary feeding and vaccination. Difference in difference analyses were used to assess outcome effects in this quasi experimental study.

The ICT-CCS intervention was implemented in areas where the BMGF-funded Ananya program (official title: Bihar Family Health Initiative) was also being implemented. Thus, the impact is of the [ICT-CCS intervention + Ananya] versus [Ananya alone]. The Ananya program was developed and implemented via a partnership of BMGF, CARE, and the Government of Bihar. The ultimate purpose of Ananya was to reduce maternal, newborn, and child mortality; fertility; and child undernutrition in Bihar, India. Ananya involved multi-level interventions designed to build front line health worker (FLW) capacities and reach to communities and households, as well as to strengthen public health facilities and quality of care to improve maternal and neonatal care and health behaviors, and thus survival. It was implemented from 2012 to 2014. Eight focal districts in western and central Bihar received Ananya, while 30 districts did not.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 3112
• Est. completion date: August 31, 2014
• Est. primary completion date: August 31, 2014
• Accepts healthy volunteers: No
• Gender: Female
• Age group: 15 Years to 65 Years

Eligibility

Inclusion Criteria:

• Mothers of infants 0-12 months residing in the catchment area of the subcenters

Exclusion Criteria:

-

Related Conditions & MeSH terms

• Child
• Health
• Infant
• Nutrition
• Pregnancy

Intervention

Behavioral:
• Information Communication Technology Continuum of Care Service
Mobile phones were made available to community health workers in the intervention arms that integrated a comprehensive set of functions to assist them in their duties, including registration and tracking of beneficiaries, automated scheduling of home visits, provision of health information through videos, guided protocols for conducting home visits through checklists, a feature to track child immunizations, and supervisory tools.

Other:
• Control Condition
Standard of care

Locations

Country	Name	City	State
n/a

Sponsors (2)

Lead Sponsor	Collaborator
Stanford University	Bill and Melinda Gates Foundation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Receipt of two or more home visits from an FLW in the final trimester of pregnancy and delivery at a facility (versus home birth), using maternal survey response	Assessed via self-report from representative sample of mothers of children aged 0-11 months; item created for Ananya Survey	2 year follow-up
Primary	Receipt of any postnatal home visits from an FLW (in the first 24 hours at home after delivery and in first month following delivery), using maternal survey response	Assessed via self-report from representative sample of mothers of children aged 0-11 months; items created for Ananya Survey.	2 year follow-up
Primary	Any complementary feeding of solid or semisolid food for infants aged 6-11 months, using maternal survey response	A survey item was used to assess complementary feeding of infants as reported by mothers of infants aged 0-11 months; items created for Ananya Survey.	2 year follow-up
Primary	Immunizations	Receipt of DBT1 and DBT3 for infants 6-11 mo; receipt of DPT3 and measles vaccine for children 12-23 months; maternal receipt of at least 2 tetanus vaccines using immunization cards or maternal self-report if not card. Data from immunization cards or from self-reports when women did not have cards; approximately 50-60% of participants did not have immunization cards	2 year follow-up
Primary	Receipt of iron-folic acid tablets by month 4 and consumption of at least 90 tablets, using maternal survey response	Assessed via self-report from representative sample of mothers of children aged 0-11 months; item created for Ananya Survey.	2 year follow-up
Primary	Clean Cord Care	Assessed via self-report from representative sample of mothers of children aged 0-11 months	2 year follow-up
Primary	Kangaroo Mother Care (skin to skin care)	Assessed via self-report from representative sample of mothers of children aged 0-11 months	2 year follow-up
Primary	Delayed Bath	Assessed via self-report from representative sample of mothers of children aged 0-11 months	2 year follow-up
Primary	Initiation of Breastfeeding	Assessed via self-report from representative sample of mothers of children aged 0-11 months	2 year follow-up
Primary	Nothing applied to cord or umbilicus	Assessed via self-report from representative sample of mothers of children aged 0-11 months	2 year follow-up
Primary	Health worker placed child unclothed on mother's chest/abdomen in skin-to-skin contact	Assessed via self-report from representative sample of mothers of children aged 0-11 months	2 year follow-up
Primary	First bath delayed by two or more days	Assessed via self-report from representative sample of mothers of children aged 0-11 months	2 year follow-up
Primary	Breastfed child within one hour of birth	Assessed via self-report from representative sample of mothers of children aged 0-11 months	2 year follow-up