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Completed

NCT Number: NCT03363308

Effects of a Health Workforce Capacity Building and Quality Improvement Intervention in Kinshasa

The aim of the study is to evaluate a health workforce capacity building and quality improvement intervention focused on integrated day-of-birth and post-pregnancy care at 16 hospitals in Kinshasa, Democratic Republic of Congo. The intervention package consists of a low-dose, high-frequency (LDHF) training of health workers, support for quality improvement teams, and provision of critical equipment, supplies and drugs within a quality improvement (QI) framework.

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Key information

Conditions

Maternal Death Death Female Urogenital Diseases and Pregnancy Complications Fetal Death Infant Death Parental Death Pathologic Processes Pathological Conditions, Signs and Symptoms Pregnancy Complications Stillbirth Urogenital Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Jhpiego DRC

Kinshasa, Democratic Republic of the Congo

About this study

The health workforce capacity building and quality improvement intervention will be implemented in two phases: eight facilities will receive the intervention in phase 1 and the remaining eight facilities will receive the intervention in phase 2.

Objective 1: For objective 2 on facility-based health outcomes, the study design is a cluster-randomized evaluation in phase 1. The intervention's effects will be assessed by comparing an intervention group and a control group of facilities. These will be selected from 16 Kinshasa health facilities. Intervention and control facilities' monthly reported health outcomes will be compared in a 12-month baseline period and 12-month period during and after the intervention implementation (Phase 1) in a difference-in-difference analysis. In Phase 2, all facilities will have their monthly service statistics and health outcomes reviewed for trends in improvement.

Overall, in Phase 1, eight intervention sites will be matched to eight sites serving as controls. In Phase 2, the eight Phase 1 control sites will then receive the same package as the intervention sites in Phase 1. Sites will be stratified by case load, low and high (over 90 births per month), and funding (public or private funding). Within each stratum, prior to start of the intervention, there will be random selection to intervention and control groups to allow for baseline comparability between groups.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Health providers:
  • Currently on the roster of maternity ward providers working at one of the 16 selected facilities at the time of the training module.
  • Willing to attend a Jhpiego clinical training workshop and offer consent as study participant.
  • Age 18 or older.

Exclusion criteria

  • there are no exclusion criteria

Treatment and study plan

training for health care workers supplmented by QI teams

Behavioral

Jhpiego will deliver maternal and newborn health and family planning (MNH+FP) training using evidence-based low-dose, high-frequency (LDHF) learning approaches and support hospital staff-led quality improvement efforts to increase the coverage of facility-based high-impact interventions, including care of the mother and newborn on the day of birth and through the first week postpartum and post abortion services.

Other names: Practice coordinator training after training session, Practice sessions using anatomic models, SMS reminder messages and quizzes, Routine calls between mentors and providers, Health information officer training, Data collection and use training, Supply of simulators, equipment, kits and other, Develop quality improvement teams and review of action plans, Routine calls between project staff and mentors

Primary outcomes

  1. Mean number or percent of items correctly answered

    Time frame: 1 day

    Each observed structured clinical exam (OSCE) or knowledge tests has between 13 and 38 items. A participant needs to achieve 85% correct score to pass at post-training to assess provider competencies. The main indicator for analysis will be the mean number of items (or percent of items) correctly answered. This mean percent of items correctly answered will be done pre-training, post-training and after 6 months. This will be done in the 8 intervention group facilities only in Phase I and again in the 8 new facilities in Phase II.

  2. Intrapartum perinatal death ratio

    Time frame: 1 day

    Defined as death of a fetus during labor who had heart tones documented on arrival in the maternity and neonatal deaths prior to 24 hours, divided by total births.

  3. Percent of women after childbirth who adopt a family planning method immediately post-pregnancy or intend to adopt a method by six weeks post-pregnancy.

    Time frame: 3 days

    Percent of women after childbirth who adopt a family planning method over all women who give birth in a facility

Secondary outcomes

  1. maternal mortality

    Time frame: 3 days

    number of maternal deaths over number of live births

Sponsors and collaborators

Lead sponsor

Jhpiego

Other

Collaborators

  • Bill and Melinda Gates Foundation

Registry information

Official study title

Effects of a Health Workforce Capacity Building and Quality Improvement Intervention on Intrapartum Stillbirth, Early Newborn Mortality and Post-pregnancy Family Planning in Kinshasa: a Cluster Randomized Evaluation

Important dates

Study start
2017
Primary completion
2020
Study completion
2020
First posted
Dec 6, 2017
Registry last updated
Jul 24, 2020

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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