Antenatal care Pregnancy and Childbirth Antenatal care
Conditions
Interventions
In this cluster randomized trial, primary care clinics are randomised 1:1 to either the intervention arm or the control arm. Randomisation was stratified based upon the qualifications of the primary s
Sponsors
Norwegian Institute for Public Health
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Clinics: 1. Community Clinics and Family Welfare Clinics situated in Matlab North or Matlab South, and their associated staff 2. Clinics with at least 1 staff member able to provide antenatal, childbirth, or postnatal care services 3. Clinics providing at least 5 antenatal care consultations per month
Exclusion criteria
Exclusion criteria: Clinics: 1. Non governmental clinics 2. Family Welfare Centers or Community Clinics located in Upazila Health Complexes. Women are excluded if their gestational age at enrollment is greater than 17 weeks.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The data for the following will be obtained from electronic medical records collected at the point of care when the antenatal care visit occurs: 1. Proportion of women who attend 4 timely antenatal care visits according to national guidelines, prospectively assessed throughout pregnancy and retrospectively between 7 and 14 days after birth. 2. Proportion of women receiving appropriate screening and management for hypertension in pregnancy, according to national guidelines, assessed throughout pregnancy. Screening is defined as measuring and recording blood pressure levels at all timely ANC visits. Management is defined as recording that a referral was done at a visit at which hypertension was identified, according to national guidelines. | — |
Secondary
| Measure | Time frame |
|---|---|
| Current secondary outcome measures as of 30/06/2020: 1. Proportion of women with anemia, hypertension or diabetes identified in pregnancy who are successfully referred to a skilled provider for additional care, prospectively collected throughout pregnancy. All data related to referrals will be obtained from electronic medical records collected at the point of care when the antenatal visit occurs. Data on success of the referral will be retrospectively assessed through an interview with the woman 7-14 days after birth. 2. Proportion of women with a facility delivery recommended during an antenatal care visit who deliver in an institution, prospectively collected throughout pregnancy and retrospectively collected 7-14 days after birth. Data on facility delivery recommendations will be obtained from electronic medical records collected at the point of care when the antenatal care visit occurs. Facility delivery status will be retrospectively assessed through an interview with the woman 7-14 days after birth. 3. Proportion of women attending a timely first antenatal care visit, retrospectively collected 7-14 days after birth. Antenatal care visit dates will be retrospectively obtained through an interview with the woman 7-14 days after birth. 4. Mean number of days of hospitalization in the first 7 days of life, retrospectively measured between 7-14 days of life. Hospitalization data will be retrospectively obtained through an interview with the woman 7-14 days after birth. 5. Proportion of births with severe morbidity/mortality (perinatal death plus hospitalization for at least 7 days) among pregnancies with any risk identified, retrospectively measured between 7 and 14 days of life. Survival data will be retrospectively obtained through an interview with the woman 7-14 days after birth. 6. Hemoglobin level, measured using a hemoglobin meter during a home visit 7-14 days aft | — |
Countries
Bangladesh
Contacts
Public ContactJ. Frederik Frøen
Outcome results
None listed