Intervention on Maternal Health Care in Rural China (CHIMACA)

F

Finnish Institute for Health and Welfare

Status

Completed

Conditions

Maternal Health

Treatments

Behavioral: health education
Other: financial
Behavioral: clinical skills training

Study type

Interventional

Funder types

Other

Identifiers

NCT01006317
015396

Details and patient eligibility

About

This project aims to strengthen and improve the performance of health care system in rural China in order to improve maternal and child health. It also provides policy-makers and health service managers with evidence for the development of informed policy on maternal and child health (MCH). The research focuses on women of reproductive age in rural areas of China as well as on their antenatal and obstetric care service providers, both clinicians and policy makers. For the Member States and China, as well as other countries it will provide a comprehensive analysis and synthesis of current state of affairs, provider and user perspectives, of antenatal and obstetric care in rural China at national and local level. This study seeks to assess whether improving financial accessibility to and quality of maternal health care increase use of and impact of maternity services. This project is implemented in 3 provinces: Anhui, Shaan'xi and Chongqing. This project will provide a practical example and information on impact of abolishing user fees on MCH service utilisation and develop and disseminate evidence-based policy recommendations on how to improve access to and quality of antenatal and obstetrical care for local and central government and international organisations, and thus serve as a step toward reaching such important goals. CHIMACA includes 3 types of interventions, two behavioural interventions and financial intervention. Behavioural interventions are training for clinical skills and training health education.

Full description

Province of Chongqing: Basic design: randomized townships (3 groups) comparing 2 different interventions to one randomised internal control group and one non-randomized external control group. In service-training: in service-training of clinical skills: Yes. In non-randomized setting, comparing in-service training to the external control group without training, and in randomized setting comparing in-service training to the internal control group without in-service training. in service-training of health education: Yes. In non-randomized setting, comparing in-service training to the external control group without training, and in randomized setting comparing in-service training to the internal control group without in-service training. Control groups: one randomized internal control group and one external non-randomised control group. 20 townships in Rongchang County are divided into 2 intervention groups and one internal control group (7 clusters) 6 townships in Tongliang County are randomly selected for an external control group Province of Shaan'xi: Basic design: Randomized townships, 5 groups (in two counties) comparing 2 different interventions to the randomized control group (Figure 2) Financial intervention: Yes. In randomized setting, comparing coverage of ante- and postnatal care to in service-training of clinical skills, in non-randomized setting comparing coverage of ante- and postnatal care to normal local coverage system (control group of matched pairs). In service-training: Clinical skills: Yes. In randomized setting, comparing in service-training of clinical skills to coverage of ante- and postnatal care, in non-randomized setting comparing in service-training of clinical skills to normal local coverage system (control group of matched pairs). Health education: Yes. In randomized setting, comparing in service training of health education to normal local system, control group (in one county) and to group of clinical skills and control group (in one county). Control group: randomized townships. - 25 townships in Zhen'an County are divided into 2 groups (12 clusters): one intervention and one control group 29 townships in Lantian County are divided into three groups (10 clusters): two intervention groups and one control group. Province of Anhui Basic design: randomized townships, 3 groups (in two counties), comparing 4 different interventions to randomized control groups (Figure 3) Financial intervention: Yes, in a randomized setting, comparing coverage of antenatal and postnatal care to the control and in-service training groups. In service-training of clinical skills: Yes, in a randomized setting, comparing the in-service training group to the control group and to the group of antenatal and postnatal care. In service-training of health education: Yes, in a randomized setting, comparing two different types of health education to the control group. Control groups: randomized townships 18 townships in Fanchang county are divided into 2 intervention groups (Group 1 and Group 2) and one control group (Group 3) 12 townships in Xuancheng county are divided into two intervention groups (Group 4 and Group 5) and one control group (Group 6).

Enrollment

108 patients

Sex

Female

Volunteers

No Healthy Volunteers

Inclusion criteria

townships with certain population size and distance to health care facilities

Exclusion criteria

townships having another intervention in health care facilities

Trial design

Primary purpose

Health Services Research

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

None (Open label)

108 participants in 4 patient groups

Control
No Intervention group
Description:
Financial coverage of MCH care within the local reimbursement system (CMS).
Clinical skills training
Experimental group
Description:
In addition to financial coverage (CMS) extensive in-service training of clinical skills (CS) to all doctors and MCH workers at the village and township level.
Treatment:
Behavioral: clinical skills training
health education
Experimental group
Description:
In addition to financial coverage extensive in-service training of health education (HE) to all doctors and MCH workers at the village and township level(Anhui, Chongqing and Shaan'xi provinces); In addition to financial coverage extensive in-service training of health education (HE) for Family planning (FP) staff at village level (Anhui).
Treatment:
Behavioral: health education
Financial
Experimental group
Description:
In addition to financial coverage of MCH care within the local reimbursement system (CMS) the coverage of ante- and postnatal care.
Treatment:
Other: financial

Trial contacts and locations

3

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Data sourced from clinicaltrials.gov

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