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A Trial of Improved Financial Access to Healthcare in Ghana

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00146692
Recruitment Status : Completed
First Posted : September 7, 2005
Last Update Posted : January 12, 2017
Dangme West Health District, Ghana
Information provided by (Responsible Party):
Brian Greenwood, London School of Hygiene and Tropical Medicine

Brief Summary:

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 or disease Intervention/treatment Phase
Malaria Behavioral: Free medical treatment Phase 4

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Study Type : Interventional  (Clinical Trial)
Enrollment : 2000 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (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
Study Start Date : April 2004
Actual Study Completion Date : February 2005

Resource links provided by the National Library of Medicine

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

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

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   6 Months to 5 Years   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

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

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00146692

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Dangme West District
Dodowa, Ghana
Sponsors and Collaborators
London School of Hygiene and Tropical Medicine
Dangme West Health District, Ghana
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Study Director: Evelyn Ansah, MD Dangme West / LSHTM
Study Chair: Christopher Whitty, FRCP LSHTM
Publications of Results:
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Responsible Party: Brian Greenwood, Professor, London School of Hygiene and Tropical Medicine Identifier: NCT00146692    
Other Study ID Numbers: ITCR5095
First Posted: September 7, 2005    Key Record Dates
Last Update Posted: January 12, 2017
Last Verified: January 2017
Keywords provided by Brian Greenwood, London School of Hygiene and Tropical Medicine:
Additional relevant MeSH terms:
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Protozoan Infections
Parasitic Diseases