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Completed

NCT Number: NCT05725278

Impact Evaluation of Triggerise's Tiko Platform

Triggerise designed web and phone based Tiko platform to connect young girls and women to the health products, services and information. The platform uses principles of behaviour economics to motivate positive choices-including rewards, promotions, discounts, coupons, reminders, alerts etc. The platform was implemented in several cities from seven states of India to provide Sexual Reproductive Health (SRH) and maternal and child health (MCH) products and services. The consumers (called Rafikis) use Tiko card to get discounts and to earn 'Tiko miles' rewards at Tiko franchised healthcare providers and pharmacies. Tiko miles are redeemable towards lifestyle products or services (e.g., beauty salons). The local Tiko health promoter (celled Pro agent) can also buy health and hygiene products at bulk discounts and sell them at profit.

Triggerise appointed Network for Engineering, Economics Research and Management (NEERMAN) to conduct an independent impact assessment of the Tiko platform with multiple research objectives include health impact evaluation at the Rafiki level.

NEERMAN used an ex-post observational design to compare usage of SRH and MCH services and family planning (FP), antenatal care (ANC) and postnatal care (PNC) practices by comparing Users and Non-Users of Tiko platform, and accounting for the selection bias statistically. The structured questionnaire collected data on knowledge, practices, barriers, enablers for SRH and MCH services, exposure o Tiko platform, and how it helped or did not help. The survey participants were approx. 1200 users and 600 non-users being served by approx. 350 pro-agents in their respective operations area.

The association between use of Tiko platform and various outcomes were identified using a generalized linear model with fixed effects at pro-agent level and including a set of covariates. To evaluate the effect modification by type of pro agent - government community health worker (CHW) versus others - an interaction model was used. The standard errors were automatically clustered at pro-agent level due to fixed effects. Primary outcomes are proportion of married Rafikis currently using any contraceptives, currently using modern short-term contraceptives, proportion of Rafikis who delivered a child post Jan 2019 and received at least 4 ANC check-ups, consumed at least 100 iron folic acid (IFA( during pregnancy, and received a PNC check-up within 6 weeks of birth.

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Key information

Conditions

Contraception Antenatal Care Iron Deficiency Anemia of Pregnancy Postnatal Care

Age range

18 year–50 year

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Primary location

NEERMAN

Mumbai, Maharashtra, 400014, India

About this study

See subsequent sections

Who can participate

Healthy volunteers accepted: Yes

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

Inclusion criteria

  • Women who are registered on Tiko Platform with Pro-agents active in 2020-21
  • Age 18-50
  • Address and contacts details are found with help of Pro-agent

Exclusion criteria

  • Does not consent to participation
  • Does not agree or confirm registering on Tiko Platform
  • If a woman is never married, she is excluded from survey on family planning but surveyed for use of Tiko platform
  • If a married woman does not have a child born on/after 1 January 2019, then she is excluded from the survey on antenatal care, delivery and postnatal care but surveyed for use of Tiko platform

Treatment and study plan

Tiko Platform Behavioural cum mHealth Intervention

Behavioral

Tiko platform is a mix of social franchising and social marketing concepts to promote health behaviours through rewards to health promoters (pro agents), healthcare providers (doctors and pharmacies), Beneficiaries (women needing FP and/or ANC services), and shop keepers and life-style service providers where beneficiaries, providers and promoters could use their rewards points. The health promoters could purchase from wholesale retailers products such as sanitary napkins, condoms and then resale these at profit. Beneficiaries were given discounts and their rewards points can be used as cash to avail certain lifestyle services at participating locations, and so did the health care providers. Pro agents also got incentives for recruiting the beneficiaries and after beneficiaries reached certain service access/use milestones. All this was integrated on a mHealth platform using smart phones and smart cards (for those without access to Tiko card).

Standard of Care / Business as Usual

Other

Non-Users of Tiko did not use Tiko platform but they could access any health care provider or pharmacy to avail same services related to Family planning, antenatal care, postnatal care

Primary outcomes

  1. Proportion of women currently using any contraceptives

    Time frame: Through survey completion, an average of 1 month

    Whether a woman used any contraceptive - traditional or modern methods, and permanent or temporary methods

  2. Proportion of women currently using modern short-term contraceptives

    Time frame: Through survey completion, an average of 1 month

    Whether a woman used modern and temporary contraception methods

  3. Proportion of women who consumed 100 or more Iron Folic Acid (IFA) tablets during last pregnancy

    Time frame: 9 months during pregnancy with the youngest child

    Whether the study participant recalled consuming 100 or more IFA tablets when pregnant with youngest child born after 1 January 2019

  4. Proportion of women who received 4 or more antenatal check-ups during last pregnancy

    Time frame: 9 months during pregnancy with the youngest child

    Whether the study participant recalled receiving 4 or more ANC check-ups from any health care provider when pregnant with youngest child born after 1 January 2019

  5. Proportion of women who received a postnatal check-up within 6 week of the delivery from a healthcare provider

    Time frame: Within 6 weeks after delivery of the youngest child

    Whether the study participant recalled receiving at least one postnatal health check up within 6 weeks of the youngest child's birth

Secondary outcomes

  1. Out of pocket expenditure on antenatal care, iron folic acid tablets, delivery, and postnatal check-ups

    Time frame: 9 months during pregnancy with the youngest child

    Reported expenditure in Indian Rupees for antenatal care, iron folic acid tablets, delivery, and postnatal check-ups associated with the youngest child born after 1 January 2019

  2. Out of pocket expenditure on Family planning services and products

    Time frame: Past 24 months (from survey date)

    Reported expenditure in Indian Rupees for permanent or temporary contraceptive methods

  3. Proportion of women receiving Antenatal check-ups at (a) Tiko franchisee doctors, (b) other private doctors, or (c) government healthcare provider

    Time frame: 9 months during pregnancy with the youngest child

    Separate proportions are estimated for each of the three locations of antenatal check-ups when pregnant with youngest child born after 1 January 2019

  4. Proportion of women receiving postnatal check-ups at (a) Tiko franchisee doctors, (b) other private doctors, or (c) government healthcare provider

    Time frame: Within 6 weeks after delivery of the youngest child

    Separate proportions are estimated for each of the three locations of postnatal check-ups within 6 weeks after delivery of the youngest child born after 1 January 2019

Sponsors and collaborators

Lead sponsor

Network for Engineering and Economics Research and Management

Other

Registry information

Official study title

Health Impact Evaluation of Triggerise's Tiko Platform

Important dates

Study start
2021
Primary completion
2021
Study completion
2022
First posted
Feb 13, 2023
Registry last updated
Feb 13, 2023

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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