Access to Health Care, Maternal Mortality
Conditions
Brief summary
The purpose of this trial is to establish if several interventions will help women in rural Tanzania access health care services during pregnancy and at the time of delivery. The interventions include education about the importance of attending antenatal care visits with nurses and facility deliveries, a voucher for transport to access the health facility at the time of delivery, and supplies to be used either at the health facility, or on route if the women does not make it to the health facility.
Detailed description
In order to reduce the number of women dying in childbirth and to improve women's health in pregnancy, this trial is designed to assess if several interventions combined can increase the number of women delivering in health care facilities. The design of the study is Multiple Baseline Design. Community health workers are trained to collect baseline data on women using mobile phones in one rural district in Tanzania. The district has four distinct divisions. After 6 months of baseline data in the district, one division will experience the interventions. The interventions are education about the importance of attending antenatal care visits with nurses and facility deliveries, a voucher for transport to access the health facility at the time of delivery, and birthing supplies to be used either at the health facility, or on route if the women does not make it to the health facility. The intervention will be begun in each of the other divisions in 3 month intervals (i.e. the second division starts to experience the interventions 3 months after the first, the third, 3 months after the second and the fourth 3 months after the third). The trial will continue for a total of 27 months including the baseline period.
Interventions
BEHAVIORALVillage meeting and travel vouchers
The interventions are: 1. Village meetings by community health workers to educate women and their families about safe birthing. 2. Vouchers for free transport by motorcycle taxi drivers to access health facility at delivery.
DEVICEBirth kit with misoprostol
Provision of birth kit with clean delivery supplies (soap, 2 pairs of gloves, 2 cord clamps, surgical blade, and 600 mcg misoprostol for the woman to take immediately after the delivery to prevent postpartum hemorrhage).
Sponsors
Ottawa Hospital Research Institute
Shirati KMT Hospital
Bruyère Health Research Institute.
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Healthy volunteers
Yes
Inclusion criteria
1. Women must be pregnant. 2. Women must live in Rorya District, but not in Shirati Town. 3. Women must deliver in Rorya District .
Exclusion criteria
1. Women who live outside or deliver outside of Rorya District. 2. Women who deliver preterm, before they have exposure to all the interventions.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Facility births | During baseline vs during intervention periods until end of study (2 years) | Number of women attending health facilities for delivery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Antenatal Care visits | During baseline vs during intervention until end of study (2 years) | Number of times women attend health facility for antenatal visits |
| Postpartum visits | During baseline vs during intervention until end of study (2 years) | Number of women attending health facility for postpartum visits |
| Use of transport intervention | During Intervention until end of study (2 years) | Number of women using the free transport intervention |
| Use of birth kit | During Intervention until end of study (2 years) | Number of women using the birth kit |
Countries
Tanzania
Outcome results
None listed