Evaluation of the Maternal and Child Survival Program (MCSP) in Mozambique Using Mixed Methods

Knowledge, Attitudes, Practice Clinical Trial

Official title:

Evaluation of the Maternal and Child Survival Program (MCSP) in Mozambique Using Mixed Methods

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03774602
• Other study ID #: IRB 8902
• Status: Completed
• Phase: N/A
• Start date: November 22, 2018
• Est. completion date: December 22, 2018

Study information

• Verified date: February 2019
• Source: Jhpiego
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study evaluates changes in knowledge, attitudes, practices and coverage of key reproductive, maternal, newborn, and child health (RMNCH) areas, including malaria, family planning (FP), nutrition, water, sanitation and hygiene (WASH), and gender equity among the population in Nampula and Sofala provinces targeted by the Maternal and Child Survival Program (MCSP) in Mozambique.

Description:

The specific objectives of the study are to:

1. Assess changes in knowledge, attitudes, practices and coverage (KAPC) of high-impact interventions related to MNCH (antenatal care, delivery, post-partum/natal care, and sick child care), immunization, family planning and reproductive health, nutrition, WASH and malaria among mothers and fathers of children age 0-23 months in MCSP supported areas;

2. Evaluate the effectiveness of male engagement interventions that encourage couples communication at increasing antenatal care (ANC) attendance, joint birth preparedness and complication readiness (BPCR) plans, institutional birth, and use of modern FP;

3. Determine the feasibility and acceptability of male engagement interventions on RMNCH services for clients and providers;

4. Explore how decisions between couples are made and what may influence their decisions about seeking RMNCH services; and

5. Explore the experiences of women who were referred to a health facility for themselves or their child for obstetric, newborn or child health complications, and examine the factors contributing to whether and how those referrals were completed in Nampula Province.

This study is a final program evaluation that will use a mixed methods approach, including both quantitative and qualitative data collection.

Quantitative data will be collected through a cross-sectional KAPC household survey of mothers and fathers of children age 0-23 months, replicating the same KAPC questionnaire that was conducted at baseline in 2016 in the same geographic areas. Questions were harmonized with the DHS and MICS where appropriate. Findings from the endline KAPC survey will be compared to findings from the baseline survey to assess changes over time in the primary outcomes of interest.

Qualitative data will be collected through focus group discussions (FGDs) and in-depth interviews (IDIs) with clients (mothers and fathers of children age 0-23 months) and health providers in MCSP-supported areas. The qualitative component will be conducted to help us gain a more in-depth understanding of the influence of male engagement interventions on couples' decision-making and care-seeking related to RMNCH as well as the barriers and facilitators that affected the experience of identified women who were referred to health facilities for obstetric or newborn complications. We will explore both client and provider experiences with gender-equitable male engagement practices, as well as individual client referral narratives related to obstetric or newborn complications.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 2767
• Est. completion date: December 22, 2018
• Est. primary completion date: December 22, 2018
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 15 Years to 49 Years

Eligibility

Inclusion Criteria (KAPC survey):

• Women 15 years and older who have had a live birth in the 2 years preceding the survey and the child is living at the time of the interview

• Male partners (age 18 and older) of women 15 years and older who have had a live birth in the 2 years preceding the survey and the child is living at the time of the interview

Exclusion Criteria (KAPC survey): Women 15-17 years without parent permission to participate in study

Inclusion Criteria (Referral narrative interviews): Women who: a) delivered in the last 12 months who experienced obstetric complications; b) whose newborn experienced complications in the last year; c) whose child 0-59 months experienced an illness in the last year

Inclusion Criteria (Provider interviews):

• Facility managers working in selected primary health care centers

• Health care workers who provide RMNCH services in MCSP-supported facility in one of these six areas: ANC, maternity, postnatal care, FP, sick child, or well-child

Exclusion Criteria (Provider interviews): Has been working in the facility for < 6 months

Inclusion Criteria (Male engagement FGDs):

• Women 18-49 years of age who delivered in the last 12 months

• Male partner (age 18 and older) of a woman 18-49 years of age who delivered in the last 12 months

• Participated in a community dialogue

Related Conditions & MeSH terms

• Gender Issues
• Knowledge, Attitudes, Practice

Intervention

Behavioral:
• Health promotion and provision of RMNCH services
Implementation of quality, high-impact interventions at institutional and community levels to increase access to and utilization of RMNCH services

Locations

Country	Name	City	State
Mozambique	Angoche District, Community Setting	Angoche	Nampula
Mozambique	Beira City, Community Setting	Beira	Sofala
Mozambique	Buzi District, Community Setting	Buzi	Sofala
Mozambique	Centro de Saude Ampara	Buzi	Sofala
Mozambique	Centro de Saude Bandua	Buzi	Sofala
Mozambique	Dondo District, Community Setting	Dondo	Sofala
Mozambique	Meconta District, Community Setting	Meconta	Nampula
Mozambique	Mecuburi District, Community Setting	Mecuburi	Nampula
Mozambique	Moma District, Community Setting	Moma	Nampula
Mozambique	Monapo District, Community Setting	Monapo	Nampula
Mozambique	Mossuril District, Community Setting	Mossuril	Nampula
Mozambique	Centro de Saude Ontupaia	Nacala	Nampula
Mozambique	Centro de Saude Quissinmanjulo	Nacala	Nampula
Mozambique	Nacala Porto District, Community Setting	Nacala	Nampula
Mozambique	Erati District, Community Setting	Namapa-erati	Nampula
Mozambique	Centro de Saude Metuchira	Nhamatanda	Sofala
Mozambique	Hospital Rural de Nhamatanda	Nhamatanda	Sofala
Mozambique	Nhamatanda District, Community Setting	Nhamatanda	Sofala
Mozambique	Centro de Saude Iapala Sede	Ribaue	Nampula
Mozambique	Hospital Rural de Ribaue	Ribaue	Nampula
Mozambique	Ribaue District, Community Setting	Ribaue	Nampula

Sponsors (4)

Lead Sponsor	Collaborator
Jhpiego	Ministry of Health, Mozambique, Save the Children, United States Agency for International Development (USAID)

Country where clinical trial is conducted

Mozambique, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Institutional delivery rate	Percentage of last-born children age 0-23 months who were born in a health facility	2 years
Primary	Percentage of pregnant women who had four or more ANC visits	Percentage of mothers of children age 0-23 months who had four or more antenatal care visits while pregnant with their youngest child	2 years
Primary	Percentage of children under 2 years of age who received Penta 1 vaccination but did not receive Penta 3 (Drop out rate)	Percentage of children age 12-23 months who received a Penta 1 vaccination but did not receive a Penta 3 vaccination according to or card verified at the time of the survey	2 years
Primary	Percentage of mothers who made birth preparations before giving birth	Percentage of mothers of children age 0-23 months who made birth preparations before the birth of their youngest child	2 years
Secondary	Percentage of women who have discussed FP use with her partner	Percentage of women of reproductive age who have discussed with her partner whether to use a FP method	2 years
Secondary	Percent of infants under 6 months of age who are exclusively breastfed	Percentage of infants 0-5 months of age who are fed exclusively with breast milk	2 years