Nutritional Status, Primary Health Care for Children
Conditions
Keywords
mHealth, decision-support tools, community health workers, primary health care, posyandu
Brief summary
This research is a collaborative study between Indonesia's Strategic Development Initiatives (CISDI), Knowledge Partnership Platform Australia - Indonesia (KONEKSI), Center on Child Protection and Wellbeing (PUSKAPA), and Center for Development Economics and Sustainability at Monash University. This study is a part of the PN PRIMA research universe, which is a program lead by CISDI with a focus of strengthening the primary healthcare facilities of Indonesia, known as Integrated Health Posts (Posyandu). This project supports the Ministry of Health's (MoH) flagship program: the Integrated Primary Health Care Services (ILP). This study aims to evaluate the impact of implementing a digital mHealth app, called the PN PRIMA app, in enhancing the work quality of Community Health Workers working in Posyandu, known as Kader. This study specifically improve the PN PRIMA app from a web-based platform to a mobile application. We aim to improve data quality, streamline service delivery workflows, and enhance decision-making support for community health workers. The enhanced version incorporates new features and Gender Equality, Disability, and Social Inclusion (GEDSI) framework to strengthen primary health care delivery. Impact evaluation of the study will be conducted through a three-arm parallel cluster randomized controlled trial. Posyandu will be the unit in which randomization will occur. The primary outcomes focuses on the improvements of Kader Posyandu performance in delivering follow-up home visits and how the app effectively support Kader in delivering nutrition interventions for children under five years of age. The study will be conducted in the Puskesmas PN PRIMA catchment area, located in Kabupaten Bekasi and Kota Depok, focusing the intervention at the Posyandu level. In total, 38 Posyandu out of 12 health centers (Puskesmas) across the two areas will be recruited to take part in this study.
Interventions
DEVICEWeb-Based Apps PRIMA
Apps PRIMA (posyandu monitoring tools) is delivered using a web-based app accessible through web browsers with basic core functionalities
DEVICEApps PRIMA Mobile
Enhancement of Apps PRIMA delivered using a standalone mobile app. Enhanced core functionalities include the looping system of children measurements, automatic charts, and GEDSI-sensitive features
BEHAVIORALAdvance GEDSI Training
Additional training to address vulnerabilities in communities and empathetic service from CHWs to caregivers. The training is a follow-up training from a basic GEDSI materials already delivered to CHWs
Sponsors
Center for Indonesia's Strategic Development Initiatives
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
DOUBLE (Subject, Caregiver)
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* Community Health Workers (CHWs) assigned to work in one of the eligible Posyandu PN PRIMA * Consent to participate in the program and the study
Exclusion criteria
\- Community Health Workers working outside of Posyandu PN PRIMA
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| At least one visitation completed | From intervention roll-out to the end of intervention period in 6 months | The proportion of U5 children's visitation cycles in which CHWs completed at least the one required home visitation according to the app-generated schedule. For each cycle, a score of 1 is coded if the assigned CHW completes at least one visitation session within the scheduled time window, and 0 if none of the scheduled visitation was delivered. The final proportion is calculated as the number of cycles coded 1 in proportion to the total number of visitation cycles assigned to the CHW. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of on-time and completed visitation | Every visitation conducted by CHW during the intervention period, marked by 6-month after the first use of app after training | The measure captures the proportion of required visits that were completed on time for each child's visitation cycle. Within each cycle, visits conducted within the recommended time window were assigned a score of 1. The total number of on-time visits for each child was calculated by summing the score. The final proportion was calculated by dividing the score of actual on-time visits by the total number of required visits. |
| Knowledge and Attitude of CHWs | Measured in baseline (pre-intervention; maximum 1 months before training intervention) and endline (post-intervention; minimum 6 months intervention implementation) | Kader's knowledge on children's nutritional needs and status, and attitudes toward vulnerable population |
| Caregiver's knowledge and attitude | Measured in baseline (pre-intervention; maximum 1 months before training intervention) and endline (post-intervention; minimum 6 months intervention implementation) | Parents/caregivers knowledge on children's nutrition and primary care services, and attitudes towards primary healthcare services |
| Caregiver's satisfaction on healthcare | Measured in baseline (pre-intervention; maximum 1 months before training intervention) and endline (post-intervention; minimum 6 months intervention implementation) | Parents/caregivers satisfaction towards primary healthcare services |
Countries
Indonesia
Outcome results
None listed