Contraceptive Usage Clinical Trial
Official title:
Community-based Provision of Urine Pregnancy Tests as Linkage to Reproductive Health Services
Kenyan families experience persistently high rates of maternal and neonatal mortality, which disproportionately affects women with low income and education and those who live far from health services. Key proven interventions include prevention of pregnancy and birth spacing, early entry to antenatal care, and facility delivery. However, creative, cost-effective interventions are urgently needed to link particularly vulnerable populations with these important health services. Previous research has shown that equipping community health volunteers (CHVs) with a tool as simple as a urine pregnancy test and training to provide post-test counseling is effective in improving linkages to antenatal care and family planning services. The invesitgators' proposal includes a multi-phase process to collect qualitative data through a needs assessment (Phase 1), use community input to develop (Phase 2) and implement a pilot intervention study (Phase 3) assessing the ability of CHV-based provision of urine pregnancy tests with CHV-provided and phone-based post-test counseling to link women with antenatal care and family planning services, and collect qualitative program evaluation data (Phase 4). This will provide much-needed information for how to effectively utilize and strengthen CHVs as part of a sustainable reproductive health care delivery system to improve maternal and neonatal mortality. The broad objectives are to determine whether the use of community-based provision of urine pregnancy tests with post-test counseling and referral to care is acceptable to community health volunteers (CHVs) and participants and to determine which method of post-test counseling and referral to care, CHV-provided or phone-based, is more acceptable and more effective. Participant outcomes, including the primary outcome of utilization of ANC or family planning care, will be measured by telephone questionnaires one to three months post-enrollment. CHV outcomes will be determined by telephone questionnaires as well as review of CHV log books.
Kenyan families experience persistently high rates of maternal and neonatal morbidity and
mortality, which disproportionately affects women with low educational attainment and income
and those who live far from health services. Key proven interventions include prevention of
pregnancy and birth spacing, early entry to antenatal care, and facility delivery. However,
creative, cost-effective interventions are urgently needed to link particularly vulnerable
populations with these important health services. Previous research has shown that equipping
community health volunteers with a tool as simple as a urine pregnancy test and training to
provide post-test counseling is effective in improving linkages to antenatal care and family
planning services. The investigators' proposal includes a multi-phase process to collect
qualitative data through a needs assessment, use community input to develop and implement a
pilot study assessing the ability of CHV-based provision of urine pregnancy tests with
CHV-provided and phone-based post-test counseling to link women with antenatal care and
family planning services, and collect qualitative program evaluation data. This will provide
much-needed information for how to effectively utilize and strengthen CHVs as part of a
sustainable reproductive health care delivery system to improve maternal and neonatal
mortality.
Expected outcomes include important qualitative data regarding the needs and preferences of
women and CHVs to improve reproductive health services. Additionally, the investigators will
perform a quantitative comparison of CHV-provided and phone-based post-test counseling to
inform further research projects and CHV services. The investigators will plan to publish
this clinical research in international peer-reviewed journals and to host community events
to share the results of the study. The investigators anticipate that the outcomes from this
pilot research will allow them to apply for research funding for expansion of this
intervention throughout the catchment area to evaluate its effects on key population health
outcomes, including maternal and neonatal mortality.
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