A cluster randomized implementation trial to measure the effectiveness of an intervention package aiming to increase the utilization of skilled birth attendants by women for childbirth: study protocol
| Autor: | Bishnu P Choulagai, Janak Thapa, Sharad Onta, Mahesh K Maskey, Narayan Subedi, G P Bhandari |
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| Jazyk: | angličtina |
| Předmět: |
Adult
Male Population Allied Health Personnel Psychological intervention Developing country Midwifery Health Services Accessibility Study Protocol Nepal Health facility Nursing Pregnancy Obstetrics and Gynaecology Cluster Analysis Humans Medicine Childbirth Maternal Health Services education Home Childbirth Retrospective Studies education.field_of_study business.industry Infant Newborn Obstetrics and Gynecology medicine.disease Community mobilization Female Maternal death Health Facilities Rural Health Services business |
| Zdroj: | BMC Pregnancy and Childbirth |
| ISSN: | 1471-2393 |
| DOI: | 10.1186/1471-2393-14-109 |
| Popis: | Background Nepal is on track to achieve MDG 5 but there is a huge sub-national disparity with existing high maternal mortality in western and hilly regions. The national priority is to reduce this disparity to achieve the goal at sub-national level. Evidences from developing countries show that increasing utilization of skilled attendant at birth is an important indicator for reducing maternal death. Further, there is a very low utilization during childbirth in western and hilly regions of Nepal which clearly depicts the barriers in utilization of skilled birth attendants. So, there is a need to overcome the identified barriers to increase the utilization thereby decreasing the maternal mortality. The hypothesis of this study is that through a package of interventions the utilization of skilled birth attendants will be increased and hence improve maternal health in Nepal. Method/Design This study involves a cluster randomized controlled trial involving approximately 5000 pregnant women in 36 clusters. The 18 intervention clusters will receive the following interventions: i) mobilization of family support for pregnant women to reach the health facility, ii) availability of emergency funds for institutional childbirth, iii) availability of transport options to reach a health facility for childbirth, iv) training to health workers on communication skills, v) security provisions for SBAs to reach services 24/24 through community mobilization; 18 control clusters will not receive the intervention package. The final evaluation of the intervention is planned to be completed by October 2014. Primary study output of this study is utilization of SBA services. Secondary study outputs measure the uptake of antenatal care, post natal checkup for mother and baby, availability of transportation for childbirth, operation of emergency fund, improved reception of women at health services, and improved physical security of SBAs. Discussion The intervention package is designed to increase the utilization of skilled birth attendants by overcoming the barriers related to awareness, finance, transport, security etc. If proven effective, the Ministry of Health has committed to scale up the intervention package throughout the country. Trial registration number ISRCTN78892490. |
| Databáze: | OpenAIRE |
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