A Skills and Drills Intervention for Emergency Obstetrics and Neonatal Care at First Referral Units of North Karnataka

President and Fellows of Harvard College

Status: Completed

Conditions: Obstructed/Prolonged Labor; Preeclampsia/Eclampsia; Obstetric and Perinatal Complications; Birth Asphyxia; Postpartum Hemorrhage; Sepsis

Treatments: Other: Skills training; Other: Emergency obstetric drills; Other: Revised Case Sheets; Other: Referral strengthening; Other: Supportive supervision

Study type: Interventional

Funder types: Other

Identifiers

NCT01865656

REF/2013/05/005058 (Registry Identifier)

MHTF IR India

Details and patient eligibility

About

To evaluate the effectiveness of a First Referral Unit (FRU) Emergency Obstetric and Newborn Care (EmONC) skills and drills intervention, to estimate the appropriateness and effectiveness of referrals in intervention arm compared to control arm and to calculate the incremental cost and cost effectiveness of EmONC skills and drills intervention.

Full description

The aim of this intervention is to improve the quality of care for institutional births with a special focus on improving the quality of Emergency Obstetric and Newborn Care (EmONC). This intervention will focus on improving the skills and practices of providers and through the improvement of referral networks, ensure timely and appropriate management of complications.

The specific objectives include:

1. Evaluate the effectiveness of an FRU-level Basic and EmONC Skills and Drills intervention combined with the existing primary health centre (PHC) based nurse mentoring intervention in improving appropriate diagnosis and management of obstetric and perinatal complications.
2. Assess the additional benefit of the EmONC Skills and drills intervention at FRUs in terms of improvement of obstetric and perinatal outcomes compared to the PHC-level intervention alone.
3. Estimate the appropriateness and effectiveness of referrals in intervention facilities compared to controls.
4. Calculate the incremental cost and cost-effectiveness of the EmONC skills and drills intervention

Enrollment: 15,018 patients

Sex: All

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

All women age who are referred or admitted directly to the first referral unit for a delivery or with a complication Staff working in the First Referral Units

Exclusion criteria

no specific exclusion criteria

Trial design

Primary purpose: Prevention

Allocation: Non-Randomized

Interventional model: Single Group Assignment

Masking: None (Open label)

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15,018 participants in 2 patient groups

4 intervention first referral units

Other group

Description:

A Quasi-experimental intervention/control trial will be implemented to assess the impact of the following interventions on the outcome measures in a cluster of 4 intervention sites relative to a matched cluster of 4 control sites: Refresher/simulation training to improve provider skills/knowledge Implementation of Emergency Obstetric Drills Revised Case sheets(for data collection and therefore part of both control and intervention sites), Mentoring and Supportive supervision, and Referral Strengthening

Treatment:

Other: Referral strengthening

Other: Skills training

Other: Supportive supervision

Other: Revised Case Sheets

Other: Emergency obstetric drills

Control Arm

No Intervention group