Health Systems, electronic Community Health Information Systems, Antenatal clinic uptake, Pregnancy
Conditions
Interventions
C it control or standard of care
The combined C it DU it intervention
Sponsors
Liverpool School of Tropical Medicine
Eligibility
Sex/Gender
Female
Inclusion criteria
Inclusion criteria: Inclusion criteria of clusters Government or faith-based ANC clinics. Located in Homa Bay County mainland. Health facilities have at least 80 attended births per year ANCs linked with at least one fully-functional community health unit Eligibility criteria for participants Pregnant women of all ages willing to participate Written informed consent A resident of the study area (catchment area) for the duration of the pregnancy Delivered and still within the 6-week post-partum period. Inclusion criteria health economic evaluation Pregnant women of all ages willing to participate Written informed consent A resident of the study area (catchment area) for the duration of the pregnancy Attending ANC clinic at a study site
Exclusion criteria
Exclusion criteria: Exclusion criteria clusters Referral hospitalsCitDUit Trial Protocol Located in Homa Bay County islands Hard to reach like very limited road and public transport access and or seasonal Currently involved in another study targeting pregnant women directly Exclusion criteria for participants Currently enrolled in another interventional study targeting pregnant women Outside the 6-week post-partum period. Exclusion criteria health economic evaluation Currently enrolled in another interventional study targeting pregnant women Attending ANC clinic in non-study sites
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Efficacy- The proportion of women having at least eight ANC contacts during the antenatal period, defined as either a scheduled ANC visit in the facility or a scheduled ANC contact with a CHV in the community assessed at birth (or within the first 6-8 weeks for home births) using the ANC cards.;Health Economics- Absolute costs to the pregnant woman and their household and the costs as a proportion of the pregnant woman and their household’s monthly income or expenditure/consumption will be calculated for the following variables: Out-of-pocket medical costs, Out-of-pocket non-medical costs, Lost income, time, and productivity and Socioeconomic impact and access to social protection will be measured by:Proportion of women using financial coping strategies and their frequency and distribution, Proportion of women eligible for, covered by and/or using health insurance including the National Hospital Insurance Fund (NHIF) and Linda Mama scheme for pregnant women | — |
Secondary
| Measure | Time frame |
|---|---|
| Efficacy-The proportion of women having at least four scheduled ANC visits in the facility The proportion of women having at least eight scheduled ANC visits in the facility The frequency (count) of scheduled ANC visits in the facility The frequency (count) of ANC visits in the community ;Health economics-CHE prevalence at two World Health Organization-defined thresholds: out-ofpocket medical costs of more than 10% of a patient household’s total monthly expenditure/consumption (10%-threshold) and out-of-pocket medical costs of more than 40% of a patient household’s monthly capacity to pay (non-food/housing/utilities expenditure/consumption) A sensitivity analysis of the proportion of women’s households incurring CHE due to pregnancy and ANC visits using varying additional recognised calculations and thresholds including, as per WHO Tuberculosis Patient Cost Survey methodology, the addition of non-medical out-of-pocket costs and lost income in the numerator. Incremental cost-effectiveness ratios (ICERs) compared across trial arms and also Equity of access to ANC and the interventions will be evaluated by exploratory distributional or “extended”) cost-effectiveness analysis of the intervention across the following subgroups: poverty quintiles, age groups including adolescents vs adults, study sites, HIV status, and by eligibilty insurance including NHIF and Linda Mama.;Exploratory-The proportion of women receiving testing and management of all four common conditions in pregnancy (HIV, syphilis, malaria,anaemia). The proportion of HIV-negative women receiving testing and management for HIV in the 3rd trimester or at delivery and also The proportion of HIV-exposed infants with negative HIV PCR DNA tests at 6-8 weeks. | — |
Countries
Kenya
Contacts
Public ContactHellen;Feiko Barsosio;ter Kuile
principle investigator;chief investigator
Outcome results
None listed