Contraceptive Usage Clinical Trial
Official title:
Randomized Controlled Trial to Address Unintended Pregnancy Rates in Low Resource Settings
This is a clinical trial investigating the impact of social accountability interventions on contraceptive use in Western Kenya. Social accountability interventions aim to improve the performance of healthcare providers via public monitoring of provider performance. This study aims to implement and evaluate two social accountability interventions: the community score card and the citizen report card. All public-sector healthcare facilities in Kisumu Country will be considered for enrollment; facility staff and residents of corresponding facility catchment areas will be randomized to one of the two treatments or the control arm.
Status | Recruiting |
Enrollment | 147 |
Est. completion date | July 1, 2024 |
Est. primary completion date | July 1, 2024 |
Accepts healthy volunteers | No |
Gender | Female |
Age group | 15 Years to 49 Years |
Eligibility | Inclusion Criteria: Women's level survey: - Women aged 15-49 years; - Reside in randomly selected households. Provider Survey: - Healthcare service provider; - Provides family planning or reproductive health services; - Works in a public-sector healthcare facility located in Kisumu County. Focus Group Discussions: - Key intervention facilitators; - Over the age of 18 years Qualitative In-Depth Interviews: - Community members in Kisumu County who participated in intervention activities; - Family planning service providers who work within a public-sector healthcare facility in Kisumu County; - Over 18 years of age. |
Country | Name | City | State |
---|---|---|---|
Kenya | Innovations for Poverty Action | Kisumu |
Lead Sponsor | Collaborator |
---|---|
University of North Carolina, Chapel Hill | Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Innovations for Poverty Action, Safe Water and AIDS Project |
Kenya,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Percentage change in current modern contraceptive use | The measure of current modern contraceptive use is a binary variable (0=non-use; 1=use), attained by first asking participants, "Are you (or your partner) currently doing something or using any method to delay or avoid getting pregnant?" Those with an affirmative response are then asked, "What method are you using?" Modern contraceptive methods will be defined to include female or male sterilization, intrauterine device, implant, injectable contraception, oral contraceptive pill, male or female condom, and any other modern methods. The current modern contraceptive use measure is implemented in the women's individual-level questionnaire in the pre- and post-intervention surveys. | Baseline, 12 months | |
Primary | Percent change in women's knowledge of patient rights | The measure of women's knowledge of patient rights is a 7 item scale with answers on a 5 point Likert scale. Possible scores range from 7 to 35. Higher scores reflect greater knowledge of patient rights. The measure of women's knowledge of patient rights is implemented in the women's individual-level questionnaire in the pre- and post-intervention surveys. | Baseline, 12 months | |
Primary | Percent change in women's agency within their community | The measure of women's agency within their community is an 8 item scale. Answers are on a 5 point scale with options "Completely sure" "Sure" "Neither sure or unsure" "Not sure" or "Not sure at all." Possible scores range from 8 to 40. Higher scores reflect greater agency for women within their community. The measure of women's agency within their community is implemented in the women's individual-level questionnaire in the pre- and post-intervention surveys. | Baseline, 12 months | |
Primary | Percent change in women's agency within a healthcare facility | The measure of women's agency within a healthcare facility is a 2 item scale. Answers are on a 5 point scale with options "Completely sure" "Sure" "Neither sure or unsure" "Not sure" or "Not sure at all." Possible scores range from 2 to 10. Higher scores reflect greater agency for women within a healthcare facility. The measure of women's agency within a healthcare facility is implemented in the women's individual-level questionnaire in the pre- and post-intervention surveys. | Baseline, 12 months | |
Primary | Percent change in women's facility satisfaction | The measure of women's facility satisfaction is an 11 item scale with answers on a 5 point Likert scale. Possible scores range from 11 to 55. Higher scores reflect greater facility satisfaction. The measure of women's facility satisfaction is implemented in the women's individual-level questionnaire in the pre- and post-intervention surveys. | Baseline, 12 months | |
Primary | Percent change in community empowerment | The measure of community empowerment is a 4 item scale with answers on a 5 point Likert scale. Possible scores range from 4 to 20. Higher scores reflect greater community empowerment. The measure of community empowerment is implemented in the women's individual-level questionnaire in the pre- and post-intervention surveys. | Baseline, 12 months | |
Primary | Percent change in community involvement | There are three indicators measuring community involvement. All indicators have a binary response option (Yes/No). The greater the number of affirmative responses, the greater the community involvement. The community involvement measures are implemented in the women's individual-level questionnaire in the pre- and post-intervention surveys. | Baseline, 12 months | |
Primary | Percent change in perceived quality of family planning service delivery | Perceived quality of family planning service delivery is measured via a 20 item scale with answers on a 4 point Likert scale. Possible scores range from 20 to 80. Higher scores reflect greater perceived quality of family planning service delivery. The measure of perceived quality is implemented in the women's individual-level questionnaire in the pre- and post-intervention surveys. | Baseline, 12 months | |
Primary | Percent change in provider absenteeism | The measure of absenteeism is a binary variable obtained by asking facility staff whether the providers on the provider work roster are present. Response options for each provider include Yes and No and up to 10 providers at each facility will be assessed for absence. The percent of providers absent will be measured by taking the number of providers absent and dividing by the total number of providers listed on the roster. The measure of provider absenteeism is implemented in the facility-level unannounced visitor questionnaire in the pre- and post-intervention surveys. | Baseline, 12 months | |
Primary | Percent change in the Method Information Index Plus (MII+) | The Method Information Index Plus (MII+) consists of four questions: "Were you informed about other methods?" "Were you informed about side effects?" "Were you told what to do if you experienced side effects?" "Were you told about the possibility of switching to another method if the method you selected was not suitable?" The reported value is the percentage of women who responded "yes" to all four questions. MII+ is measured in the mystery client questionnaire in the pre- and post-intervention surveys. | Baseline, 12 months | |
Primary | Percent change in informal payment solicitation | The measure of informal payment solicitation is a binary variable obtained by asking mystery clients whether they were asked by facility staff to pay when seeking family planning services at a public-sector healthcare facility. Response options include Yes and No. The percent of mystery client visits in which an informal payment is solicited will be measured by taking the number of mystery client visits for which an informal fee is solicited and dividing by the total number of mystery client visits. The measure of informal payments is implemented in the mystery client questionnaire in the pre- and post-intervention surveys. | Baseline, 12 months | |
Primary | Percent change in patient mistreatment | The measure of patient mistreatment is a binary variable obtained by asking mystery clients "Did your provider do any of the following?" Response options include Shouted at me; Scolded me or treated me with scorn; Threatened to withhold services; Called me by an insulting name; Laughed at me; Other type of disrespect, please explain. If the mystery client selects any of the response options, patient mistreatment is considered to occur. The percent of mystery client visits in which patient mistreatment occurs will be measured by taking the number of mystery client visits for which mistreatment occurs and dividing by the total number of mystery client visits. The measure of patient mistreatment is implemented in the mystery client questionnaire in the pre- and post-intervention surveys. | Baseline, 12 months | |
Primary | Percent change in the close-to-community (CTC) provider motivation indicator scale | The CTC provider motivation indicator scale is a 12 item scale. Answers are on a 5 point Likert scale. Possible scores range from 12 to 60. Higher scores reflect greater provider motivation. The measure of provider motivation is implemented in the facility-level provider's questionnaire in the pre- and post-intervention surveys. | Baseline, 12 months |
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