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A Trial of Improved Financial Access to Healthcare in Ghana

This study has been completed.
Dangme West Health District, Ghana
Information provided by (Responsible Party):
Brian Greenwood, London School of Hygiene and Tropical Medicine Identifier:
First received: September 5, 2005
Last updated: January 11, 2017
Last verified: January 2017

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
Behavioral: Free medical treatment
Phase 4

Study Type: Interventional
Study Design: Allocation: Randomized
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 London School of Hygiene and Tropical Medicine:

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


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
  Contacts and Locations
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, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00146692

Dangme West District
Dodowa, Ghana
Sponsors and Collaborators
London School of Hygiene and Tropical Medicine
Dangme West Health District, Ghana
Study Director: Evelyn Ansah, MD Dangme West / LSHTM
Study Chair: Christopher Whitty, FRCP LSHTM
  More Information

Responsible Party: Brian Greenwood, Professor, London School of Hygiene and Tropical Medicine Identifier: NCT00146692     History of Changes
Other Study ID Numbers: ITCR5095
Study First Received: September 5, 2005
Last Updated: January 11, 2017

Keywords provided by London School of Hygiene and Tropical Medicine:

Additional relevant MeSH terms:
Protozoan Infections
Parasitic Diseases processed this record on May 25, 2017