Infant Mortality Clinical Trial
Official title:
Integrating Pediatric Care Delivery in Rural Healthcare Systems
Globally, over seven million children under the age of five die each year, although a suite of interventions—safe delivery care, neonatal care and resuscitation, and management of childhood diarrhea, malnutrition, and pneumonia—can prevent many of these deaths when implemented within functioning health systems. This study will include a quasi experimental, stepped wedge, cluster-controlled trial of a mobile health care coordination and quality improvement intervention designed to facilitate comprehensive health systems strengthening. It will do this through training and equipping community-level health care clinics to manage chronic diseases through use of the Chronic Care Model, structured quality improvement sessions to promote clinical mentorship, and use of an integrated electronic medical record to provide real-time data for disease surveillance. The investigators hypothesize that improving upon the health system in these ways will lead to a 25% reduction in under-two mortality through improved services for the citizens of Achham, Nepal.
Status | Recruiting |
Enrollment | 7000 |
Est. completion date | October 2019 |
Est. primary completion date | October 2019 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | Female |
Age group | 15 Years to 49 Years |
Eligibility |
Inclusion Criteria: - Female - Reproductive age, 15-49 years - Resides within 14 village clusters that comprise experimental/control arms Exclusion Criteria: |
Country | Name | City | State |
---|---|---|---|
Nepal | Charikot Primary Health Center | Bhimeshwor | Dolakha |
Nepal | Bayalpata Hospital | Sanfebagar | Achham |
Lead Sponsor | Collaborator |
---|---|
Possible | Brigham and Women's Hospital, National Institutes of Health (NIH) |
Nepal,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Under-two mortality rate | We expect the intervention will lead to a 25% decrease in under-two mortality in the experimental arm. | Five years | |
Primary | Infant mortality rate | We expect the intervention will lead to a 25% decrease in the infant mortality rate in the experimental arm. | Five years | |
Primary | Neonatal mortality rate | We expect the intervention will lead to a 25% decrease in the neonatal mortality rate in the experimental arm. | Five years | |
Secondary | Institutional Birth Rate | We expect the intervention will lead to a 25% increase in Institutional Birth Rate among reproductive-age women in the experimental arm. | Five years | |
Secondary | Antenatal Care Completion Percentage | We expect the intervention will lead to a 25% increase in number of pregnant women completing all 4 antenatal care visits in the experimental arm. | Five years | |
Secondary | Postpartum contraceptive prevalence rate | We expect the intervention will lead to a 20% increase in postpartum contraceptive prevalence rate among reproductive age women who have delivered in the past 2 years in the experimental arm. | Five years | |
Secondary | Preterm delivery rate | We expect the intervention will lead to 25% fewer preterm births in the experimental arm. | Five years | |
Secondary | Low birthweight delivery rates | We expect the intervention will lead to a 25% reduction in babies born with low birthweights in the experimental arm | Five years | |
Secondary | Percentage of stillbirths | We expect the intervention will lead to 25% fewer stillbirths in the experimental arm. | Five years |
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