Impact of a Smartphone Intervention on Tanzanian Women's Childbirth Location (SUSTAIN1)

University of Toronto

Status: Completed

Conditions: Maternal Death Affecting Fetus or Newborn; Delivery Problem for Fetus; Obstetric Complication; Delivery; Injury, Maternal; Birth Injuries; Delivery Complication

Treatments: Behavioral: SUSTAIN Paperbased training of CHW (SOC); Behavioral: SUSTAIN Smartphone training of CHW (SP+)

Study type: Interventional

Funder types: Other

Identifiers

NCT03161184

28832

Details and patient eligibility

About

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.

Full description

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.

Enrollment: 572 patients

Sex: Female

Ages: 16 to 49 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• client of one of the CHWs enrolled in the mHealth study
• visited at least once by a CHW following intervention (baseline training for CHWs) and during their most recent pregnancy
• most recent delivery was a live birth and the child is still living

Exclusion criteria

• None

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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572 participants in 2 patient groups

Control (paper based)

Active Comparator group

Description:

Women received prenatal household visits from CHWs who were trained on the Tanzania Ministry of Health and Social Welfare's National integrated Maternal, Newborn and Child Health (i-MNCH) paper-based protocols, i.e. received intervention "SUSTAIN Paperbased training of CHW (SOC)"

Treatment:

Behavioral: SUSTAIN Paperbased training of CHW (SOC)

Intervention (Smart phone assisted)

Experimental group

Description:

Women received prenatal household visits from CHWs trained on the following: A) National i-MNCH programme; and B) Smartphone-assisted counseling protocol: a smartphone application designed to assist with identification of danger signs during pregnancy, referral to health facilities, and MNCH counseling , i.e. received intervention "SUSTAIN Smartphone training of CHW (SP+)"

Treatment:

Behavioral: SUSTAIN Paperbased training of CHW (SOC)

Behavioral: SUSTAIN Smartphone training of CHW (SP+)