Clinical Trial: Impact of a Smartphone Intervention on Tanzanian Women's Childbirth Location

Study Status: Completed
Recruit Status: Completed
Study Type: Interventional

Official Title: Evaluation of an mHealth Intervention to Improve Women's Access to Maternal Health Services in Rural Tanzania

Brief Summary: This study investigates whether training Community Health Workers (CHW) to use a smartphone-based prenatal counseling application as a "job aid" instead of the existing paper based standard is associated with increased women's use of maternal health services in Singida region, Tanzania.

Detailed Summary:

In low-income countries, frontline community health workers (CHWs) have potential to improve women's access to maternal health services through prenatal counseling and referral. However, CHW performance can often be enhanced with sufficient training, incentives, supportive supervision and job aids. Smartphone-based applications designed to assist CHWs with referrals, health education and client counseling may improve the quality of care delivered during household visits. There is a need for rigorous scientific studies on the impact of such interventions.

This study investigates whether CHWs' use of a smartphone-based application increases women's use of maternal health services in Singida region, Tanzania. It is hypothesized that smartphone-assisted counselling by CHWs can increase use of health facility-based delivery services compared to a control group of CHWs using standard paper-based protocols. This study is conducted within the context of larger project - SUSTAIN-MNCH Project (Supporting Systems to Improve Nutrition, Maternal, Newborn and Child Health), implemented by World Vision through multiple partners.

Sponsor: University of Toronto

Current Primary Outcome:

• Delivery in a facility [ Time Frame: Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months) ]
  Participant delivered at or on the way to a health facility, measured by retrospective report at time of interview, after delivery
• Antenatal care attendance [ Time Frame: Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months) ]
  Whether participant attended 4 ANC visits or more during their most recent pregnancy

Original Primary Outcome: Same as current

Current Secondary Outcome:

• Gestational age at first contact/ANC [ Time Frame: Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months) ]
  Number of months into pregnancy the participant had first ANC visit
• Iron supplementation during pregnancy [ Time Frame: Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months) ]
  Whether participant received 100 IFA tablets during pregnancy
• HIV screening HIV Screening [ Time Frame: Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months) ]
  Whether the participant was screened for HIV during pregnancy
• De-worming treatment during pregnancy [ Time Frame: Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months) ]
  Whether the participant reported during interview taking any listed de-worming medication during pregnancy
• Bednet use [ Time Frame: Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months) ]
  Whether the participant slept under an insecticide treated bed net during pregnancy
• Malaria prophylaxis during pregnancy [ Time Frame: Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months) ]
  Whether the participant reported during interview receiving two doses of IPTp during pregnancy
• Tetanus Toxoid Vaccination [ Time Frame: Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months) ]
  Whether the participant received two TT vaccinations during pregnancy
• Referrals [ Time Frame: Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months) ]
  Whether the participant was referred to a clinic during pregnancy by a CHW
• Referral uptake [ Time Frame: Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months) ]
  Whether a referred participant went to the facility during pregnancy
• Presence of partner at ANC [ Time Frame: Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months) ]
  Whether the participant's husband/spouse accompanied her to at least one ANC visit
• Birth plan [ Time Frame: Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months) ]
  Whether the participant developed a birth plan during pregnancy
• Early initiation of breastfeeding [ Time Frame: Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months) ]
  Whether the participant initiated breastfeeding within 1 hour after birth
• Exclusive breastfeeding at 7 days [ Time Frame: Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months) ]
  Whether the participant breastfed exclusively for the first week after birth
• BCG vaccination [ Time Frame: Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months) ]
  Whether the participant's child received BCG vaccination within the first week of life
• Maternal knowledge of danger signs during pregnancy [ Time Frame: Time between the participant's first prenatal visit by a trained CHW and the date of the postnatal household interview (up to 10 months) ]
  Number of pregnancy danger signs listed by participant

Original Secondary Outcome: Same as current

Information By: University of Toronto

Dates:
Date Received: May 1, 2017
Date Started: July 23, 2013
Date Completion:
Last Updated: May 18, 2017
Last Verified: May 2017