Team-Based Goals and Incentives for Community-Based Health Workers to Promote Maternal and Child Health in Bihar, India

Stanford University

Status: Completed

Conditions: Healthy

Treatments: Behavioral: Team-Based Goals and Incentives; Other: Control Condition

Study type: Interventional

Funder types: Other

Identifiers

NCT03561012

TBGI

Details and patient eligibility

About

This study is designed to evaluate the impact of team-based goals and performance-based incentives for community-based health workers on health-promoting behaviors among women related to reproductive, maternal, newborn and child health and nutrition in Bihar, India.

The intervention was funded by the Bill and Melinda Gates Foundation (BMGF) and implemented from 2012 to 2014. Health sub-centers in the catchment areas of five blocks (sub-districts) of the district of Bengusarai were randomly assigned to treatment or control arms (38 sub-centers were assigned to each). Data were collected in the Intervention and Control areas from mothers of infants 0-12 months at baseline and at 2.5-year follow-up, to assess the intervention's effects on quality and quantity of FLW home visits, postnatal health behaviors, and among older infants/toddlers, complementary feeding and vaccination. Difference in difference analyses were used to assess outcome effects in this quasi experimental study.

The TBGI intervention was implemented in areas where the BMGF-funded Ananya program (official title: Bihar Family Health Initiative) was also being implemented. Thus, the impact is of the [TBGI intervention + Ananya] versus [Ananya alone]. The Ananya program was developed and implemented via a partnership of BMGF and the Government of Bihar. The ultimate purpose of Ananya was to reduce maternal, newborn, and child mortality; fertility; and child undernutrition in Bihar, India. Ananya involved multi-level interventions designed to build front line health worker (FLW) capacities and reach to communities and households, as well as to strengthen public health facilities and quality of care to improve maternal and neonatal care and health behaviors, and thus survival. It was implemented from 2012 to 2014. Eight focal districts in western and central Bihar received Ananya, while 30 districts did not.

Enrollment: 3,581 patients

Sex: Female

Ages: 15 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Mothers of infants 0-12 months residing in the catchment area of the subcenters (public health facilities)

Exclusion criteria

Trial design

Primary purpose: Health Services Research

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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3,581 participants in 2 patient groups

Intervention arm

Experimental group

Treatment:

Behavioral: Team-Based Goals and Incentives

Control Arm

Active Comparator group

Treatment:

Other: Control Condition