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NCT Number: NCT01480544

Improving Maternal and Child Health in India: Evaluating Demand and Supply Side Strategies (IMATCHINE)

The study evaluates the impact of a new conditional cash transfer (CCT) program (Thayi Bhagya Yojana) to promote child birth in obstetric facilities in the state of Karnataka, India in order to determine its policy value and to guide efforts to improve maternal and infant health outcomes nationally. In addition, the study includes a large randomized evaluation of performance-based incentive payments to providers to improve quality of medical care provided during delivery and actual health improvement in the providers' patient populations and their catchment areas.

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Key information

Conditions

Obstetric Labor Complications Female Urogenital Diseases and Pregnancy Complications Hemorrhage Hypertension, Pregnancy-Induced Infections Inflammation Neonatal Mortality Pathologic Processes Pathological Conditions, Signs and Symptoms Post-partum Hemorrhage Postpartum Hemorrhage Pre-Eclampsia Pregnancy Complications Puerperal Disorders Sepsis Systemic Inflammatory Response Syndrome Urogenital Diseases Uterine Hemorrhage

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Imatchine

Bangalore, Karnataka, India

About this study

The evaluation study will first provide new evidence on the effectiveness of demand-side strategies to increase institutional deliveries and improve childbirth outcomes. Second, the study will analyze one of the first implementations of direct rewards to providers for health improvement in a developing country. Third, the study will provide critical new insight into dynamics between demand and supply-side incentives in improving population health outcomes as either complements or substitutes.

The study uses household survey to collect data from mothers on socio-economic, human capital, quality of life variables (including below poverty line [BPL] index components) and as well as information about deliveries, fertility histories, morbidity and mortality (for mothers, infants, and children), birth related complications, health service use and spending. Additionally, provider surveys will collect data on infrastructure, staffing, provider qualifications, provider knowledge and process measures of provider performance.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Households with new mothers (one to three weeks after childbirth)
  • Rural private sector maternity care providers who are listed on the Karnataka government's legitimate provider list.

Exclusion criteria

  • Households without children
  • Households where mothers gave birth > 3 weeks ago
  • Public sector maternity care providers
  • Private sector maternity care providers serving in towns with large public providers such as Community Health Centers (CHCs)

Treatment and study plan

Experimental: Treatment 1

Other

Physicians will receive financial incentives for improving the quality of obstetric and neonatal care provided to mothers and newborns as reported by mothers during household interviews.

Experimental: Treatment 2

Other

Physicians will receive financial incentives for improving maternal and neonatal health outcomes as reported by mothers during household interviews.

Primary outcomes

  1. Increase institutional deliveries and improve maternal and infant health outcomes in the population.

    Time frame: 1 Year

    Rates of deliveries in hospitals and maternal health complications such as obstetric fistulas, post-partum hemorrhage, sepsis, as well as neonatal outcomes.

Secondary outcomes

  1. Effectiveness of financial incentives to maternity care private providers for improvements in the clinical quality of services in the providers' patient populations and the catchment areas they serve.

    Time frame: 1 Year

    Indicators of quality of services include monitoring of the fetal heartbeat, active management of labor, and monitoring of cervical dilation and effacement.

  2. Effectiveness of financial incentives to maternity care private providers for improvements in maternal and infant health outcomes in the providers' patient populations and the catchment areas they serve.

    Time frame: 1 Year

    Indicators of improvements in maternal and neonatal health outcomes include reduced incidence of maternal morbidity outcomes such as obstetric fistulas, excessive post partum bleeding, sepsis, hospital readmission, as well as neonatal outcomes.

Sponsors and collaborators

Lead sponsor

Duke University

Other

Collaborators

  • Department for International Development, United Kingdom
  • International Initiative for Impact Evaluation
  • Sambodhi Research and Communication Pvt., Ltd.
  • Stanford University

Registry information

Official study title

Improving Maternal and Child Health in India: Evaluating Demand and Supply Side Strategies

Acronym: IMATCHINE

Important dates

Study start
2012
Primary completion
2014
Study completion
2015
First posted
Nov 29, 2011
Registry last updated
Dec 16, 2015

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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