An Incentive-Based and Community Health Worker Package Intervention to Improve Early Utilization of Antenatal Care: Evidence from a Pilot Randomised Controlled Trial

Autor:	Laura Rossouw, Ronelle Burger, Rulof Burger
Rok vydání:	2019
Předmět:	Adult Employee Incentive Plans medicine.medical_specialty Time Factors Adolescent Epidemiology Psychological intervention Pilot Projects Context (language use) Health Promotion law.invention South Africa 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Pregnancy law Intervention (counseling) medicine Humans 030212 general & internal medicine Community Health Workers 030219 obstetrics & reproductive medicine business.industry Public health Public Health Environmental and Occupational Health Social Support Obstetrics and Gynecology Prenatal Care Incentive Standardized mortality ratio Family medicine Pediatrics Perinatology and Child Health Community health Female business
Zdroj:	Maternal and Child Health Journal. 23:633-640
ISSN:	1573-6628 1092-7875
DOI:	10.1007/s10995-018-2677-9
Popis:	Objectives One of the factors linked to South Africa's relatively high maternal mortality ratio is late utilization of antenatal care (ANC). Early utilization is especially important in South Africa due to the high HIV prevalence amongst pregnant women. This study examined the impact of a package intervention, consisting of an incentive called the Thula Baba Box (TBB) and a community health worker (CHW) programme, on early utilization of ANC. Methods A pilot randomised controlled trial consisting of 72 women aged 18 and older was conducted in an urban area in South Africa to evaluate the impact of the package intervention. Women were recruited and randomised into either intervention (n = 39) or control group (n = 33). The intervention group received both the TBB and monthly CHW visits, while the control group followed standard clinical practice. Both groups were interviewed at recruitment and once again after giving birth. The outcomes measured are the timing of first ANC visit and whether they attended more than four times. It is anticipated that the box will also have a beneficial impact on infant health outcomes, but these fall out of the scope of this study. Results Women in the intervention groups sought care on average 1.35 months earlier than the control group. They were also significantly more likely to attend at least four antenatal clinic visits. Conclusions for practice Given the South African context and the importance of early care-seeking behaviour to improve health outcomes of HIV-positive pregnant women, the intervention can help to improve maternal and neonatal health outcomes. Further research is needed to investigate the impact of the two interventions separately, and to see if these findings hold in other communities.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ecd145e71a90b97a2a49a1057b6350d0 https://doi.org/10.1007/s10995-018-2677-9 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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