Improving Perinatal Outcomes Using Conditional and Targeted Transfers

Utilization, Health Care Clinical Trial

— IMPACTT  

Official title:

Improving Perinatal Outcomes Using Conditional and Targeted Transfers

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT04090762
• Other study ID #: R01HD090231
• Status: Active, not recruiting
• Phase: N/A
• Start date: July 8, 2019
• Est. completion date: April 30, 2024

Study information

• Verified date: November 2023
• Source: RAND
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

It has been estimated that increasing the use of skilled care during childbirth could prevent up to 1.5 million maternal and newborn deaths and stillbirths by 2025. Conditional cash transfer programs, in which women receive cash payments conditioned on the use of maternal health services, are increasingly being used as a mechanism to increase uptake. In this study, the investigators randomly assign households to receive varying cash amounts conditioned on uptake of recommended pregnancy and delivery care. The investigators crosscut this with an intervention in which pregnant women receive information about their risk type. This randomized trial will provide new evidence about the potential efficacy of targeting cash transfers by pregnancy risk. This study will take place in 288 primary health service areas (HSAs) in Nigeria.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 36607
• Est. completion date: April 30, 2024
• Est. primary completion date: June 30, 2021
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: Female
• Age group: 15 Years to 49 Years

Eligibility

Inclusion Criteria:

• Pregnant women ages 15-49 who reside in the participating health service areas

Exclusion Criteria:

• none

Related Conditions & MeSH terms

• Birth Outcomes
• Utilization, Health Care

Intervention

Behavioral:
• Conditional cash transfer
Pregnant women receive cash payments conditioned on their use of prenatal services and use of a health facility for child birth.
• Risk information provision
Pregnant women who exhibit characteristics associated with a greater risk of a poor birth outcome - these will be identified from the medical and epidemiological literature - will be informed that they possess these characteristics.

Locations

Country	Name	City	State
Nigeria	Aminu Kano Teaching Hospital	Kano

Sponsors (1)

Lead Sponsor	Collaborator
RAND

Country where clinical trial is conducted

Nigeria, 

References & Publications (2)

Okeke EN, Abubakar IS, De Guttry R. In Nigeria, Stillbirths And Newborn Deaths Increased During The COVID-19 Pandemic. Health Aff (Millwood). 2021 Nov;40(11):1797-1805. doi: 10.1377/hlthaff.2021.00659. Epub 2021 Oct 20. — View Citation

Okeke EN. Playing defense? Health care in the era of Covid. J Health Econ. 2022 Sep;85:102665. doi: 10.1016/j.jhealeco.2022.102665. Epub 2022 Jul 25. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Maternal depression	Depression assessed using the Edinburgh Postnatal Depression Scale	3-4 months after anticipated childbirth/delivery date
Other	Health facility choice	Probability of receiving care at a government or private hospital	3-4 months after anticipated childbirth/delivery date
Primary	Probability of prenatal care	the probability of receiving prenatal care	3-4 months after anticipated childbirth/delivery date
Primary	Uptake of prenatal care	the number of prenatal visits completed	3-4 months after anticipated childbirth/delivery date
Primary	Uptake of health facility birth	probability of giving birth at a health facility	3-4 months after anticipated childbirth/delivery date
Primary	Child mortality - fetal loss	Child mortality - fetal loss	3-4 months after anticipated childbirth/delivery date
Primary	Child mortality - stillbirths	Child mortality - stillbirths	3-4 months after anticipated childbirth/delivery date
Primary	Child mortality - early infant death	Child mortality - early infant death	3-4 months after anticipated childbirth/delivery date
Secondary	Maternal health	delivery complications	3-4 months after anticipated childbirth/delivery date
Secondary	Maternal mortality	maternal death	3-4 months after anticipated childbirth/delivery date
Secondary	Child weight	Child weight	3-4 months after anticipated childbirth/delivery date
Secondary	Child length	Child length	3-4 months after anticipated childbirth/delivery date
Secondary	Uptake of postnatal care	Probability of using postnatal care	3-4 months after anticipated childbirth/delivery date
Secondary	Child vaccination	Probability of receiving recommended child immunizations	3-4 months after anticipated childbirth/delivery date
Secondary	Maternal beliefs	Risk perceptions and beliefs assessed using a questionnaire	3-4 months after anticipated childbirth/delivery date
Secondary	Pregnancy behavior - tetanus vaccination	Probability of receiving tetanus vaccination	3-4 months after anticipated childbirth/delivery date
Secondary	Pregnancy behavior - malaria prophylaxis	Probability of receiving malaria prophylaxis	3-4 months after anticipated childbirth/delivery date
Secondary	Pregnancy behavior - blood building products	Probability of receiving blood building products	3-4 months after anticipated childbirth/delivery date
Secondary	Pregnancy behavior - dietary consumption	Probability of consuming nutrient-rich foods assessed using questionnaire	3-4 months after anticipated childbirth/delivery date
Secondary	Quality of perinatal care	Quality score assessed using a questionnaire	3-4 months after anticipated childbirth/delivery date
Secondary	Timely initiation of prenatal care	Probability of initiating prenatal care in the first trimester of pregnancy	3-4 months after anticipated childbirth/delivery date
Secondary	Maternal work	Hours worked in the last seven days	3-4 months after enrollment