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To evaluate if increased supervision and support of South African Government health workers' home visits improves maternal and child outcomes: study protocol for a randomized control trial.
- Source :
- Trials; 8/7/2017, Vol. 18, p1-10, 10p, 1 Diagram, 3 Charts
- Publication Year :
- 2017
-
Abstract
- <bold>Background: </bold>Concurrent epidemics of HIV, depression, alcohol abuse, and partner violence threaten maternal and child health (MCH) in South Africa. Although home visiting has been repeatedly demonstrated efficacious in research evaluations, efficacy disappears when programs are scaled broadly. In this cluster randomized controlled trial (RCT), we examine whether the benefits of ongoing accountability and supervision within an existing government funded and implemented community health workers (CHW) home visiting program ensure the effectiveness of home visiting.<bold>Methods/design: </bold>In the deeply rural, Eastern Cape of South Africa, CHW will be hired by the government and will be initially trained by the Philani Programme to conduct home visits with all pregnant mothers and their children until the children are 2 years old. Eight clinics will be randomized to receive either (1) the Accountable Care Condition in which additional monitoring and accountability systems that Philani routinely uses are implemented (4 clinics, 16 CHW, 450 households); or (2) a Standard Care Condition of initial Philani training, but with supervision and monitoring being delivered by local government structures and systems (4 clinics, 21 CHW, 450 households). In the Accountable Care Condition areas, the CHW's mobile phone reports, which are time-location stamped, will be monitored and data-informed supervision will be provided, as well as monitoring growth, medical adherence, mental health, and alcohol use outcomes. Interviewers will independently assess outcomes at pregnancy at 3, 6, 15, and 24 months post-birth. The primary outcome will be a composite score of documenting maternal HIV/TB testing, linkage to care, treatment adherence and retention, as well as child physical growth, cognitive functioning, and child behavior and developmental milestones.<bold>Discussion: </bold>The proposed cluster RCT will evaluate whether routinely implementing supervision and accountability procedures and monitoring CHWs' over time will improve MCH outcomes over the first 2 years of life.<bold>Trial Registration: </bold>ClinicalTrials.gov registration #NCT02957799 , registered on October 26, 2016. [ABSTRACT FROM AUTHOR]
- Subjects :
- MEDICAL personnel
MATERNAL health services
CHILD health services
INTIMATE partner violence
MENTAL depression
HIV infections
ALCOHOLISM
DIAGNOSIS of alcoholism
ALCOHOLISM treatment
DIAGNOSIS of HIV infections
THERAPEUTICS
HIV infection epidemiology
AGE distribution
ATTITUDE (Psychology)
BREASTFEEDING
CHILD development
COMMUNITY health workers
COMPARATIVE studies
EXPERIMENTAL design
HEALTH attitudes
HOME care services
RESEARCH methodology
MEDICAL cooperation
PARENTING
RESEARCH
RESEARCH funding
RURAL health services
TIME
SOCIAL responsibility
GOVERNMENT regulation
EVALUATION research
RANDOMIZED controlled trials
PSYCHOLOGY
Subjects
Details
- Language :
- English
- ISSN :
- 17456215
- Volume :
- 18
- Database :
- Complementary Index
- Journal :
- Trials
- Publication Type :
- Academic Journal
- Accession number :
- 124556737
- Full Text :
- https://doi.org/10.1186/s13063-017-2074-5