Health Care Utilization, Contraception, Family Planning Services, Rural Health, Health Access
Conditions
Interventions
HAC Facilitated Integrated Community Health Outreach
Status quo comparison
Sponsors
The Ohio State University
Eligibility
Sex/Gender
Female
Inclusion criteria
Inclusion criteria: Inclusion Criteria for health facility subject: - Health facilities must be located in a district where HAC has permission to operate. - Health facilities must have at least two villages in their catchment area that meet the criteria for outreach services. Inclusion Criteria for direct village subject: - Direct villages must be located at least 4 km from the health facility or require more than 45 minutes of travel time to reach the health facility. - Direct villages must be within the health facility catchment area. - Direct villages must have a population of at least 150 residents. - Health workers at the corresponding health facility must be willing to conduct regular outreach visits to serve the direct village if the facility is randomized to the intervention arm. Inclusion Criteria for indirect village subject: - Indirect communities must be located within 4 km of the health facility or reachable in less than 45 minutes of travel time. - Indirect communities must be within the health facility catchment area and ineligible to receive HAC outreach services. Inclusion criteria for household subject: - Households must include at least one woman aged 18 to 35 who is currently not pregnant and at least six months postpartum. - In villages where the original household eligibility criteria do not yield the required number of eligible households, the household eligibility age range may be relaxed to include women aged 18 to 45.
Exclusion criteria
Exclusion criteria: Exclusion Criteria for health facility subject: - Health facilities are excluded if there is a specific directive from the District Health Officer requiring the health facility, or villages within its catchment area, to offer outreach services from that health facility. Exclusion Criteria for village subject: - Direct villages are excluded if HAC determines that the village cannot be served because of logistical constraints or infeasibility. Exclusion Criteria for household subject: - Households are excluded if they do not include an eligible woman under the applicable age, pregnancy, and postpartum criteria. - Households are excluded if the eligible respondent does not provide informed consent.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Healthcare utilization in the past 30 days. Indicator for whether an individual received any healthcare service in the past 30 days, measured through the household survey. This outcome will be measured for all household members in the sample and may be analyzed overall and by age subgroup. ;Current contraceptive use among eligible women. Indicator for whether the primary female respondent is currently using any contraceptive method at the time of the follow-up survey. Women who are pregnant at endline will be coded as non-users of contraception, consistent with the study protocol. | — |
Secondary
| Measure | Time frame |
|---|---|
| Current modern contraceptive use among eligible women. Indicator for whether the primary female respondent is currently using a modern contraceptive method at the time of the follow-up survey. Modern methods include contraceptive implants, intrauterine devices, injectables, sterilization, condoms, oral contraceptive pills, emergency contraception, the Standard Days Method, and other modern contraceptive methods. ;Contraceptive concordance with fertility preferences. Measure of alignment between the respondent's fertility preferences and contraceptive behavior, based on household survey responses about fertility preferences and contraceptive use. ;Days of usual activity lost due to illness or health reasons ;Adult labor force participation;Health facility service delivery outcomes. Measures of health facility operations and service delivery, including patient volumes, staffing, medication and commodity inventories, stockouts, and facility management practices, measured through health facility surveys and administrative or monitoring data. ;Indirect effects on healthcare utilization in facility proximate communities. Healthcare utilization outcomes among households living near study health facilities and not eligible to receive HAC outreach services. These outcomes are used to assess whether the outreach intervention affects service availability or use among facility-proximate populations. ;Indirect effects on current contraceptive use in facility proximate communities. Current contraceptive use among eligible women living near study health facilities and not eligible to receive HAC outreach services. | — |
Countries
Uganda
Contacts
Public ContactAnne;Anthony Fitzpatrick;Kamwesige
Associate Professor;Research Manager
Outcome results
None listed