A Trial of Improved Financial Access to Healthcare in Ghana

This study has been completed.
Sponsor:
Collaborator:
Dangme West Health District, Ghana
Information provided by:
Gates Malaria Partnership
ClinicalTrials.gov Identifier:
NCT00146692
First received: September 5, 2005
Last updated: March 5, 2009
Last verified: March 2009
  Purpose

Effective control strategies for malaria depend both on preventing disease and on treating those who become infected to prevent significant morbidity and mortality. There are many barriers to preventing access to prompt and effective treatment, some of which are amenable to intervention, others (such as distance to healthcare) less so. This study will concentrate on modifiable financial barriers to care.

With the aim of increasing health service utilization and reducing morbidity and mortality among children under five, some governments are currently implementing policies aimed at reducing financial barriers to health care. There is at the same time an on-going debate concerning the relative importance of cost as a barrier to health care. Though theoretically the aim for reducing these barriers should be achieved, its actual impact has not been directly assessed or demonstrated by means of an intervention trial.

This study aims to determine by means of a randomized trial the impact of reducing such barriers on morbidity due to severe malaria among children 6 months to five years and on outpatient utilization. An existing pre-payment scheme in the study area will be utilized to improve financial access for half of 2500 households who have not registered for either year I or II. The impact on severe anaemia, mean haemoglobin and anthropometric measurements will be assessed. Health service utilisation rates will be measured in both groups by active and passive surveillance. Patient perceptions and health-seeking behaviour will be compared. The study will contribute to the current debate on the relative importance of cost of care as a barrier to health care and the potential for the removal of this barrier as a strategy for malaria control, and on methods to optimise this.


Condition Intervention Phase
Malaria
Behavioral: Free medical treatment
Phase 4

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Impact of Improved Financial Access to Health Care on Morbidity Due to Severe Malaria and Healthcare Utilization Among Children 6 Months to Five Years of Age in a Hyper Endemic Area in Ghana: a Randomized Controlled Trial

Resource links provided by NLM:


Further study details as provided by Gates Malaria Partnership:

Primary Outcome Measures:
  • Prevalence of severe anaemia among children under five years of age after peak malaria transmission season.

Secondary Outcome Measures:
  • • Mean haemoglobin count among the two groups at study end
  • • Number of admissions to hospital with malaria among children under five years of age in both groups
  • • Average number of visits to per child under five years to primary care facility among both groups
  • • Anthropometric measurements of children in the two groups
  • • All cause mortality in both groups, all ages

Estimated Enrollment: 2000
Study Start Date: April 2004
Study Completion Date: February 2005
  Show Detailed Description

  Eligibility

Ages Eligible for Study:   6 Months to 5 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Child in household aged between 6 months and 5 years
  • Informed consent from parents
  • Household to which child belongs resident in the Dodowa sub district and intending to remain resident until the end of the next two years

Exclusion Criteria:

  • Parents refuse to participate in the study
  • Household due to emigrate from study area within two years
  • Household currently enrolled
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00146692

Locations
Ghana
Dangme West District
Dodowa, Ghana
Sponsors and Collaborators
Gates Malaria Partnership
Dangme West Health District, Ghana
Investigators
Study Director: Evelyn Ansah, MD Dangme West / LSHTM
Study Chair: Christopher Whitty, FRCP LSHTM
  More Information

Publications:
Responsible Party: Dr Evelyn Ansah, Dangme West District,Dodowa, Ghana
ClinicalTrials.gov Identifier: NCT00146692     History of Changes
Other Study ID Numbers: ITCR5095
Study First Received: September 5, 2005
Last Updated: March 5, 2009
Health Authority: Ghana: Ministry of Health

Keywords provided by Gates Malaria Partnership:
Malaria
Cost
Treatment
Diagnosis
Africa
Ghana

Additional relevant MeSH terms:
Malaria
Protozoan Infections
Parasitic Diseases

ClinicalTrials.gov processed this record on April 21, 2014