Community level interventions for pre-eclampsia (CLIP) in India: A cluster randomised controlled trial
| Autor: | Joel Singer, Laura A. Magee, Avinash Kavi, Sumedha Sharma, Shivaprasad S. Goudar, Peter von Dadelszen, Umesh Ramadurg, Jeffrey N Bone, Dustin Dunsmuir, Beth A. Payne, Marianne Vidler, Ashalata Mallapur, Mrutunjaya B Bellad, Hubert Wong, Richard J. Derman, Jing Li, Amit P. Revankar, Chandrashekhar Karadiguddi, Narayan V Honnungar, Umesh Charantimath, Zulfiqar A Bhutta, Domena Tu, Hannah L. Nathan, Geetanjali Katageri, Andrew Shennan, J. Mark Ansermino, Bhalachandra S. Kodkany, Tang Lee |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Gestational hypertension
Adult medicine.medical_specialty Community health worker Referral Adolescent Psychological intervention India Article Cluster randomized controlled trial 03 medical and health sciences Young Adult 0302 clinical medicine Pre-Eclampsia Pregnancy Internal Medicine Medicine Humans 030212 general & internal medicine Cluster randomised controlled trial Mobile health Community Health Services 030219 obstetrics & reproductive medicine Eclampsia business.industry Community engagement Infant Newborn Pregnancy Outcome Obstetrics and Gynecology Odds ratio Pregnancy hypertension Middle Aged medicine.disease Triage Confidence interval Emergency medicine Female business |
| Zdroj: | Pregnancy Hypertension |
| ISSN: | 2210-7797 2210-7789 |
| Popis: | Highlights • As implemented, the CLIP intervention did not improve the primary composite outcome. • ASHAs and ANMs were able to undertake all aspects of the mobile health app-guided visits. • Women could not be reached in their communities as frequently as planned. • Eight or more POM-guided contacts were associated with fewer stillbirths supporting WHO guidance. • Community-level interventions are unlikely to improve outcomes without enhanced facility care. Objectives Pregnancy hypertension is associated with 7.1% of maternal deaths in India. The objective of this trial was to assess whether task-sharing care might reduce adverse pregnancy outcomes related to delays in triage, transport, and treatment. Study design The Indian Community-Level Interventions for Pre-eclampsia (CLIP) open-label cluster randomised controlled trial (NCT01911494) recruited pregnant women in 12 clusters (initial four-cluster internal pilot) in Belagavi and Bagalkote, Karnataka. The CLIP intervention (6 clusters) consisted of community engagement, community health workers (CHW) provided mobile health (mHeath)-guided clinical assessment, initial treatment, and referral to facility either urgently ( |
| Databáze: | OpenAIRE |
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