Improving women's attendance and engagement with antenatal care services Other
Conditions
Interventions
A mixed-methods 'before and after' study, conducted over 12 months, will assess whether a full-scale trial to test the effectiveness of an intervention to improve antenatal contacts between women and
Sponsors
Liverpool School of Tropical Medicine
Eligibility
Sex/Gender
All
Age
18 Years to 49 Years
Inclusion criteria
Inclusion criteria: Women: 1. Pregnant at the time of recruitment 2. Attending care or planning to book care in study facilities in the Manyara region 3. Age 18 years old and over at the time of recruitment 4. Willing and able to participate Healthcare workers (Nurses, midwives, doctors, support workers): 1. Delivering ANC care in primary facilities and district hospitals in the Manyara region 2. Delivering ANC in study facilities using PANDA 3. Managing PANDA medical unit at the district hospital in the Manyara region
Exclusion criteria
Exclusion criteria: Pregnant women: 1. With established obstetric complications as identified by the clinical team 2. Aged 17 years old and under Healthcare workers: 1. Only providing intrapartum and postnatal care
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Recruitment and retention of women in the study: 1.1.Women who fulfil the eligibility criteria, women who are invited to participate in the study, those recruited and any participants who leave the study before completion, recorded in a participant log at the following time points: 1.1.1. Control group: 80 pregnant women recruited at their first antenatal visit or in subsequent visits (November 2022) 1.1.2. Control group follow-up: 80 pregnant women followed up two weeks post-partum (Dec 22 – March 23) 1.1.3. Intervention group: 80 pregnant women recruited at their first or subsequent visits (April 23) 1.1.4. Control group follow-up: 80 pregnant women follow up two weeks post-partum (May – September 23) 1.2.Reasons for non-recruitment (e.g. refusal to participate, or do not consent to take part, language barrier) when approached at their first or subsequent antenatal visit at the facilities and recorded in the screening log. Permission will be sought to collect data on reasons for non-participation from women and health workers who have provided contact details but declined to take part. 1.3. Reasons for withdrawal and loss to follow-up documented in participant log during the course of the study | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Usual care (baseline – 6 months) demographic and clinical data routinely collected in the ANC register, at the first antenatal appointment, including age, civil status, address, education, obstetric data including last normal menstrual period, number of previous pregnancies and their outcomes, previous obstetric complications, medical conditions (including chronic and hereditary diseases), vaccination (including tetanus Toxoid), screening for Syphilis and HIV, records of blood pressure, haemoglobin level, fundal height, albumin in the urine (urine dipstick) and physical examination. 80 electronic case reports (one per participant) will be created in REDCap following enrolment into the study. Demographic, obstetric and medical details and screening results from the ANC register for first and subsequent visits and birth outcomes of all recruited women will be extracted from the register. 2. PANDA: (Implementation period: April – September 2023) 80 PANDA medical records (one per participant enrolled) will be created following enrolment into the study. Demographics and obstetric details will be automatically collected through PANDA which creates an electronic medical record for each woman visited. The application includes 4 modules: personal information, medical history, screening and education. Personal information includes age, ethnicity, spoken language, address/location of the visit, marital status and education. Medical history includes details about previous and index pregnancy, including place of birth, vaccinations, the onset of labour, mode of birth, maternal and infant outcomes, and antenatal and postnatal complications. The screening section includes measurement values (height, weight, blood pressure and pulse, temperature, fundal height), screening for UTI, other infections, respiratory problems and TB, and rapid-test results for HIV, syphilis, malaria, gestational diabetes, and anemia. It also includes monitoring of the baby, including fundal heig | — |
Countries
Tanzania
Outcome results
None listed