An interventional study of Performance-based monetary incentives in Maternal Death and Neonatal Death, sponsored by Harvard School of Public Health (HSPH). Completed. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2019-07-24.
Sponsored by Harvard School of Public Health (HSPH) · Not applicable, Interventional, and Prevention
The purpose of this study is to identify the causal impact of performance-based monetary incentives in increasing postnatal care (PNC) referrals by traditional birth attendants (TBAs), via a randomized controlled trial (RCT).
77 studies on the registry are indexed under Maternal Death; 19 are open to participants now.
This study's enrollment of 207 is below the median of 1,126 across 57 interventional studies indexed under Maternal Death.
Browse Maternal Death studies →Harvard School of Public Health (HSPH) is the lead sponsor of 154 studies on the registry; 10 are open to participants now.
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Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Traditional birth attendants will receive an offer of two-weekly payouts per reported delivery they take that is verified by client.
Traditional birth attendants will receive an offer of two-weekly payouts per reported delivery they take that is verified by client. Traditional birth attendants randomized to this arm will also receive an offer of two-weekly payouts per successful referral of delivery clients to postnatal care within 48 hours of delivery in a facility if verified.
Behavioral: Performance-based monetary incentives
Maternal Postnatal Care Referral
The proportion of delivery clients that are successfully referred by the traditional birth attendant for postnatal care within 48 hours of delivery. For each delivery client that the traditional birth attendant reported, we visited at least three days after delivery to ascertain if they had been asked to visit the postnatal clinic, clarify if they had visited the clinic within 48 hours of delivery, and what care they had received (if yes). The team visited traditional birth attendants every two weeks to identify new clients. Where a new client was not up to three days post-delivery, the interview was postponed until the next visit by the team to the community. This occurred repeatedly, over a five-month frame.
Time frame: Within 48 hours of delivery
Neonatal Postnatal Care Referral
Proportion of neonates delivered by the traditional birth attendant that are successfully referred for postnatal care within 48 hours of delivery
Time frame: Within 48 hours of delivery
Participants were recruited from the community within 128 wards in Ebonyi State in August 2016.
| Milestone | Control Arm | Referral Incentive Arm |
|---|---|---|
| Started | 104 | 103 |
| Completed | 102 | 98 |
| Not completed | 2 | 5 |
| Withdrew: Lost to follow-up | 1 | 3 |
| Withdrew: Death | 0 | 1 |
| Withdrew: Legal case | 0 | 1 |
| Withdrew: Protocol violation | 1 | 0 |
The proportion of delivery clients that are successfully referred by the traditional birth attendant for postnatal care within 48 hours of delivery. For each delivery client that the traditional birth attendant reported, we visited at least three days after delivery to ascertain if they had been asked to visit the postnatal clinic, clarify if they had visited the clinic within 48 hours of delivery, and what care they had received (if yes). The team visited traditional birth attendants every two weeks to identify new clients. Where a new client was not up to three days post-delivery, the interview was postponed until the next visit by the team to the community. This occurred repeatedly, over a five-month frame.
| proportion of maternal clients referred | Control Arm | Referral Incentive Arm |
|---|---|---|
| Maternal Postnatal Care Referral | 0.044 (-0.009 to 0.097) | 0.154 (0.079 to 0.229) |
Proportion of neonates delivered by the traditional birth attendant that are successfully referred for postnatal care within 48 hours of delivery
| proportion of neonates referred | Control Arm | Referral Incentive Arm |
|---|---|---|
| Neonatal Postnatal Care Referral | 0.032 (-0.015 to 0.079) | 0.126 (0.059 to 0.193) |
Collected over 5 months. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Control Arm | 0/104 (0%) | 0/104 (0%) | 0/104 (0%) |
| Referral Incentive Arm | 1/103 (1%) | 0/103 (0%) | 0/103 (0%) |
| Age, Continuous(years) | Control Arm | Referral Incentive Arm | Total |
|---|---|---|---|
| Mean | 51.42308 ± 19.67241 | 44.75728 ± 16.23206 | 48.10628 ± 18.30641 |
| Sex: Female, Male(Participants) | Control Arm | Referral Incentive Arm | Total |
|---|---|---|---|
| Female | 101 | 97 | 198 |
| Male | 3 | 6 | 9 |
| Number of participants lacking formal education(Participants) | Control Arm | Referral Incentive Arm | Total |
|---|---|---|---|
| Number | 47 | 40 | 87 |
| Average income per pregnancy(Naira) | Control Arm | Referral Incentive Arm | Total |
|---|---|---|---|
| Mean | 1790.962 ± 1852.523 | 2265.437 ± 2992.071 | 2027.053 ± 2491.036 |
| Number of participants offering postnatal care(Participants) | Control Arm | Referral Incentive Arm | Total |
|---|---|---|---|
| Number | 70 | 60 | 130 |
| Monthly average of delivery clients(clients) | Control Arm | Referral Incentive Arm | Total |
|---|---|---|---|
| Mean | 13.80769 ± 97.70553 | 9.553398 ± 48.90622 | 11.69082 ± 77.21418 |
| Number of participants that are literate in English(Participants) | Control Arm | Referral Incentive Arm | Total |
|---|---|---|---|
| Number | 44 | 47 | 91 |
| Number of participants that are literate in non-English Language(Participants) | Control Arm | Referral Incentive Arm | Total |
|---|---|---|---|
| Number | 26 | 29 | 55 |
3 further baseline measures are reported on the registry.
No study locations are listed for this record.
PDFs hosted by the registry, ClinicalTrials.gov.
Plan to share: Yes — De-identified data for this study including all the variables used for the analysis are available for download on the Harvard Dataverse.
Supporting information: Study protocol, Statistical analysis plan, Informed consent form, Analytic code
Time frame: The data on the Harvard Dataverse are available indefinitely as long as the website continues to host datasets.
Access criteria: The data can be freely downloaded without permission.
Ran from Aug 2016 to primary completion in Dec 2016, 4 months.
Results were first posted in Jul 2019, 2 years 7 months after primary completion.
Of 35 interventional studies with no phase under Maternal Death, half reached primary completion within 30 months of starting (the median), counting those still running; a quarter within 21 and three quarters within 41. This study's 4 months is below that.
How these figures are worked out, and which studies are left out of them.
This study is completed, as verified in Jul 2019. You cannot join it, but the record below documents what was studied.
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