Triage for risk assessment of pregnant women when arriving for labour and delivery at hospital Pregnancy and Childbirth
Conditions
Interventions
A cluster-randomized controlled trial (cRCT) will be integrated into the final phase of the national rollout of the OTIP training programme, covering the Central, Greater Accra and Western regions. Ha
Sponsors
Thrive Programme
Eligibility
Sex/Gender
Female
Inclusion criteria
Inclusion criteria: Intervention: Hospitals: 25 high-density hospitals in the Greater Accra, Central and Western regions that had 1,200 deliveries in 2022. Inside each hospital, midwives nominated by management or their peers to become midwife champions will receive the OTIP training and lead the cascade training, promoting and monitoring the implementation of OTIP. Data collection: 1. Midwives: midwives on permanent contracts in the maternity department, including those in charge of wards and clinics. 2. Service users: Mothers selected for interviews will be those who delivered in the hospital within the last 2 months, primarily from labour wards, postnatal wards, and postnatal care clinics. This eligibility criteria implies that the sample of mothers at baseline will be different to that at endline.
Exclusion criteria
Exclusion criteria: Surveys: 1. Midwives on long-term leave 2. Mothers with significant medical conditions or acute illnesses that may impair their ability to participate in the survey 3. Midwives or mothers who do not consent to participate after reading our privacy notice
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Process variables: representing the actual medical care received by mothers and their newborns, as reported by mothers during the in-person survey, both at baseline and at follow-up, 4 months later: 1.1. Time (in minutes) between arrival and initial assessment 1.2. Indicator capturing whether assessment received upon arrival complied with OTIP guidelines. For this, the researchers ask mothers the different vital signs measured and examinations. They will create an index capturing whether all, and -depending on variation – a certain percentage of assessments were performed. 1.3. 0/1 Indicator capturing if the doctor intervened if complications during labour and delivery at the hospital 1.4. Indicator capturing whether immediate postnatal checks complied with national guidelines. For this, the researchers ask mothers about the different vital signs measured and examinations for them and their newborns, as well as counselling on breastfeeding, danger signs, family planning, and future vaccination advice. The researchers will create an index capturing whether all, and -depending on variation – a certain percentage of assessments were performed. 2. Maternal and neonatal outcome variables: Including the health of pregnant women and newborns 2.1. 0/1 Indicator capturing whether there were complications during labour and delivery at the hospital, as reported by the mother during the in-person survey at follow-up, 4 months after. 2.2. Newborn APGAR scores (1 minute and 5 minutes) from records collected during the mother survey at baseline and follow-up, 4 months after. Depending on variation the researchers will use the actual score or a 0/1 indicator of whether the score was critical. 2.3. Maternal mortality rate at the hospital level, from DHIMS II records for every month between January 2024 and January 2025 2.4. Infant mortality rate at the hospital level, from DHIMS II records for every month between January 2024 and January 2025 | — |
Secondary
| Measure | Time frame |
|---|---|
| To examine the mechanisms behind the potential impacts of OTIP on the primary outcomes, the researchers will further consider secondary outcomes: Hospital staff outcomes measured during the midwives survey at baseline and follow-up, 4 months after: 1. Clinical knowledge measured using a standardized test developed by Kybele’s nursing researchers and GHS healthcare staff 2. Autonomy measured using Autonomy index 3. Empowerment measured using Empowerment index 4, Burnout index measured using the Maslach burnout inventory | — |
Countries
Ghana
Contacts
Public ContactAntonella;Julia Bancalari;Loh
;
Outcome results
None listed