Integrated Community Based Health Systems Strengthening Preliminary Study in Kozah Togo (ICBHSS-Kozah)

Integrate Health

Status

Unknown

Conditions

Health Service Utilization

Maternal-Child Health Services

Treatments

Other: ICBHSS model

Study type

Observational

Funder types

Other

Identifiers

NCT03773913

ICBHSS Kozah

Details and patient eligibility

About

This preliminary study aims to inform the design and delivery of the integrated facility and community-based health systems strengthening (ICBHSS) model in four Kozah District health facilities over a period of 48 months. Specific aims include: (1) Assess maternal and child health outcomes and health service utilization rates in the 4 ICBHSS model intervention sites catchment areas; (2) Identify barriers to and facilitators of access and quality services related to ICBHSS model; and (3) Assess changes in health care services coverage, effectiveness, and adoption of ICBHSS model.

Full description

Intervention: The investigators have adapted an integrated facility and community-based health systems strengthening (ICBHSS) model to improve primary healthcare services in Togo. The ICBHSS model includes a bundle of evidence based interventions including (1) community engagement meetings and feedback; (2) the elimination of facility user fees for children under five and pregnant women; (3) pro-active community based IMCI using Community Health Workers (CHWs) with additional services including linkage to family planning and counseling, HIV testing & referrals; (4) clinical mentoring and enhanced supervision at public sector facilities; and (5) improved supply chain management and facility structures.

Study: The investigators will conduct a mixed methods assessment, using the RE-AIM framework to evaluate the impact and implementation of the ICBHSS initiative in Kozah district. It will include: (1) a repeated cross-sectional study to obtain annual coverage, effectiveness, and adoption metrics using a population-based household survey as well as (2) qualitative key informant interviews and focus group discussions conducted at 12 months for each intervention health facility. The primary outcome will be under 5 year old mortality rate, with secondary outcomes including under-one mortality rate, maternal mortality rate, as well as maternal and child health service utilization.

Enrollment

1,500 estimated patients

Sex

Female

Ages

15 to 49 years old

Volunteers

Accepts Healthy Volunteers

Inclusion criteria

Female of reproductive age (aged 15-49 years)
Individuals aged 15-17 years will only be included if they have children and/or are pregnant
Lives in selected household within study catchment area
Informed consent is obtained for participants 18-49
Waiver of parental permission is obtained for 15-17 year-old participants

Exclusion criteria