Pregnancy and Childbirth
Conditions
Interventions
Usual Care
Process evaluation Key informant interviews with stakeholders
Process evaluation Semi structured interview with women
Process evaluation Semistructured interview with women
Process evaluation Semistructured interview with partners
Process evaluation Semistructured interview with partners
Process evaluation semistructured interview with health workers
Sponsors
Liverpool School of Tropical Medicine
Eligibility
Sex/Gender
Female
Inclusion criteria
Inclusion criteria: Main trial inclusion: Pregnant women (aged 18 and above) booked or planning to start their ANC at the study sites in the first and second trimester, regardless of parity. Process Evaluation inclusion: Pregnant women (age 18 and above) recruited into the study (both control and intervention arms) who: • Have actively engaged in antenatal care (>4 more visits) • Have not actively engaged in antenatal care (< 4 visits) • Partners of women (aged 18 and above) recruited into the study, who also attended at least one ANC visit with their partner. • Midwives delivering routine ANC in control sites. • Midwives using PANDA to deliver ANC to pregnant women in intervention sites. • Obstetricians / Senior Medical Officers from the Haydom Referral Hospital, in charge of validating the ANC visits received in the Medical Unit from the intervention facilities. • District health officers, Regional Health officers, representative of Ministry of Health and other key stakeholders involved in prenatal care in Manyara Region and Tanzania
Exclusion criteria
Exclusion criteria: Main trial exclusion: • Women on ‘high risk’ pathway. • Women unable/declining consent Process Evaluation exclusion: - Women who are already established on a high-risk pathway prior to recruitment. High-risk refers to women who have previous pregnancy or health complications for example hypertension, diabetes, epilepsy, thyroid disease, heart or blood disorders, poorly controlled asthma and infections, requiring referral to a higher level of care - Women unwilling to be interviewed, despite their visit conducted through PANDA. - Women who refuse to have their subsequent visits completed through PANDA - Midwives moved to a difference facility, not involved in the trial. - Midwives not in charge of ANC. - Obstetrician / Senior Medical officers unwilling to be interviewed, despite using the Medical Unit. - Key stakeholders unwilling to be interviewed despite their engagement with the PANDA research study.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| •Number of women who have >4 antenatal visits •Rate of severe perinatal morbidity and mortality (NICU admission >24hours, Apgar Score < 7 at 5 min, stillbirth, early neonatal death) | — |
Secondary
| Measure | Time frame |
|---|---|
| • Maternal antenatal experience • Maternal perceptions of respectful care • Number of antenatal referrals to central facility • Intrapartum transfer rates • Maternal clinical outcomes including mode of birth, transfusion, anaemia, severe pre-eclampsia, postpartum haemorrhage, sepsis, breastfeeding, WHO severe morbidity scale and maternal mortality (up to 6 weeks PN). • Neonatal clinical outcomes including components of the severe perinatal morbidity outcome. ;Cost-effectiveness outcomes • Cost to implement PANDA (including training and device provision) • Incremental cost-effectiveness ratios (e.g. cost per woman with >4 antenatal visits) ;Process evaluation outcomes - How PANDA has been implementation in terms of fidelity, ‘dose’, reach and adaptation made in the study context - Why the use of PANDA e-health system has increased / not increased the number of antenatal contacts between woman and providers from the perspectives of women, partners and healthcare workers. - Implementation strategy/ies for scale-up and dissemination of PANDA e-health system in other districts and region in Tanzania | — |
Countries
Tanzania
Contacts
Public ContactTina Lavender
Professor of Maternal and Newborn Health and Chief Investigator of PANDA Trial
Outcome results
None listed