Accelerating Newborn Survival in Ghana Through a Low-dose, High-frequency Health Worker Training Approach

Stillbirth Clinical Trial

Official title:

Accelerating Newborn Survival in Ghana Through a Low-dose, High-frequency Health Worker Training Approach

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03290924
• Other study ID #: OPP1087303
• Status: Completed
• Phase: N/A
• First received: September 19, 2017
• Last updated: September 21, 2017
• Start date: September 1, 2014
• Est. completion date: February 28, 2017

Study information

• Verified date: September 2017
• Source: Jhpiego
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study assesses the effect of a low-dose, high-frequency training approach on long-term evidence-based skill retention among skilled birth attendants and impact on adverse birth outcomes at hospitals in Ghana.

Description:

In-service training for skilled birth attendants (SBAs) is one of the most common interventions to address lack of knowledge and skills. However, these training interventions are seldom evaluated for effectiveness in improving learning or performance.

This study study is a cluster-randomized waitlist trial implemented in 40 public and mission hospitals in Ghana. It assesses the effect of a low-dose, high-frequency (LDHF) training approach to update hospital-based SBAs in key evidence-based intrapartum and immediate newborn care practices, using current global guidelines.The LDHF approach includes two 4-day onsite sessions (low dose) with weekly practice sessions, SMS quizzes and reminders, and mentoring via mobile phone and onsite visits between trainings (high frequency). The low-dose sessions include competency acquisition through simulation, case-based learning, and small content packages spread over short time intervals.

Eligible hospitals will be stratified by geographic region and caseload, and then randomly assigned to one of four implementation waves. The pipeline randomization allows for rigorous evaluation while the program is rolled out to all facilities.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 40
• Est. completion date: February 28, 2017
• Est. primary completion date: February 28, 2017
• Accepts healthy volunteers: No
• Gender: All
• Age group: N/A and older

Eligibility

INCLUSION CRITERIA - FACILITIES:

• Public or faith based hospital

• At least three skilled birth attendants on staff

• At least 30 births per month

EXCLUSION CRITERIA - FACILITIES:

• Private hospital

• Public or faith based hospital with less than three skilled birth attendants on staff

• Public or faith based hospital with less than 30 births per month

INCLUSION CRITERIA - SERVICE PROVIDERS:

• Health providers who attend births in participating health facilities and consent to be assessed at the time of enrollment and at several points in time over the study period

EXCLUSION CRITERIA - SERVICE PROVIDERS:

• Health providers who decline to participate

Related Conditions & MeSH terms

• Neonatal Death
• Perinatal Death
• Stillbirth

Intervention

Behavioral:
• Low dose high frequency health worker training approach
Two 4-day training sessions for skilled birth attendants 1-day peer practice coordinator training after first training session Weekly, peer-led practice sessions using MamaNatalie® and NeoNatalie™ anatomic models SMS reminder messages and quizzes Routine telephone calls between master mentors and peer practice coordinators, and between project staff and master mentors Health information officer training Data collection and use training Supply of simulators, newborn resuscitation equipment, and delivery sets
• Active Comparison
Training on data collection and reporting

Locations

Country	Name	City	State
n/a

Sponsors (2)

Lead Sponsor	Collaborator
Jhpiego	Bill and Melinda Gates Foundation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	institutional twenty-four hour newborn mortality rate	death within 24 hours, or before discharge, of a newborn who breathed at birth	1 day
Primary	institutional intrapartum stillbirth rate	proportion of all facility births that resulted in intrapartum stillbirth	1 day
Secondary	skilled birth attendant knowledge and skills	score on written and practical examinations on routine and emergency obstetric and newborn care	Pre-test (before training) - post-test (immediately after training) - endline (12 months)