Integrating Services for Noncommunicable Diseases in Continuum of Care for Mothers and Children
|Continuum of Care Noncommunicable Diseases||Behavioral: Integrating services for noncommunicable diseases in continuum of care for mothers and children Behavioral: Ordinary health education for pregnant women|
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Primary Purpose: Health Services Research
|Official Title:||Integrating Services for Noncommunicable Diseases in Continuum of Care for Mothers and Children: a Cluster Randomized Control Trial in Myanmar|
- Completion of continuum of care [ Time Frame: 3 months after delivery ]Proportion of mothers who complete four antenatal care visits, skilled birth attendance and four postnatal care visits
- Change in knowledge on NCDs and nutrition [ Time Frame: Baseline and 3 months after delivery ]Proportion of mothers who change their knowledge related to NCDs after health education on NCDs and nutrition
|Actual Study Start Date:||May 22, 2017|
|Estimated Study Completion Date:||March 31, 2018|
|Estimated Primary Completion Date:||July 1, 2017 (Final data collection date for primary outcome measure)|
Pregnant women in intervention arm will receive CoC card and health education on CoC in maternal, newborn and child health (MNCH), NCD and nutrition. The CoC card will include CoC services from first antenatal care(ANC) to last postnatal care(PNC) including four ANC, skilled birth attendance (SBA) and four PNC and essential services. Pregnant women will get stickers if they receive above services. Health education will be given three times during pregnancy and one time during postpartum period.
Behavioral: Integrating services for noncommunicable diseases in continuum of care for mothers and children
The intervention package will comprise of two components, (1) utilization of CoC card and (2) health education on CoC in maternal, newborn and child health (MNCH), NCD and nutrition. The CoC card will be distributed to mothers by midwives at the time of receiving ANC. The CoC card includes CoC services from first antenatal care(ANC) to last postnatal care(PNC) including four ANC, skilled birth attendance (SBA) and four PNC and essential services. Pregnant women will get stickers if they receive above services. Health education will be given by Public Health Supervisors 2 at the health facilities. Health education will be given three times during pregnancy and one time during postpartum period with pamphlets and posters.
Placebo Comparator: Control
Pregnant women in control arm will receive ordinary health education on pregnancy care
Behavioral: Ordinary health education for pregnant women
The ordinary health education intervention will cover schedule for ANC, delivery and PNC; danger signs; birth preparedness and nutrition. Health education will be given three times during pregnancy and one time during postpartum period with pamphlets and posters.
Antenatal care (ANC) is an important entry point for subsequent use of delivery and postnatal care (PNC) services. When women receive high-quality ANC, they will have skilled birth attendant (SBA) at delivery and continue to receive postnatal care. Continuous uptake of above services is necessary to improve health and well being of maternal, newborn and child health (MNCH). Moreover, the continuum of Care (CoC) offers the critical entry point for women and children for preventive care and health promotion on noncommunicable diseases (NCDs). ANC and PNC visits for women and a series of immunization for children are crucial opportunities to provide integrated services of NCDs. The integration of NCDs prevention and control programs in MNCH services would empower women to control NCDs in their families. However, no study has examined the effect of antenatal health education on CoC on completion of CoC among mothers in Myanmar. In addition, no study has examined the effect of antenatal health education on NCDs and nutrition on knowledge on NCDs and nutrition, and on maternal complications among mothers in Myanmar.
A cluster randomized controlled trial will be done among pregnant women living in study area. The unit of randomization in this study will be "rural health center (RHC)". In each RHC, there are at least four Sub-centers (SCs). RHC including SCs will be considered as one cluster. The investigators will advocate midwives (MW) on the CoC in MNCH and introduce the CoC card. The investigators will also recruit and train Public Health Supervisors 2 (PHS2) in each cluster to provide health education to pregnant women on CoC in MNCH, NCDs and nutrition.
We will conduct the study in three townships (Pantanaw, Inapu, Wakema,) in Ayeyarwaddy region, Myanmar from May 2017 to March 2018. There are a total of 22 health facilities. Out of 22 health facilities in 3 townships, eleven will be allocated into intervention arm and another 11 into control arm. An analyst, who will not be a primary member of the study team, will conduct randomization of clusters using computer-generated random sequences. Estimated sample size of 1200 pregnant women will be recruited, roughly 400 pregnant women in each township. The investigators estimate that about 28 women will seek ANC within one month in each cluster. In total of 22 clusters, the investigators estimate 600 women will seek ANC within one month; therefore, the enrollment period will take two months to get the targeted sample size of 1,200 pregnant women.
Please refer to this study by its ClinicalTrials.gov identifier: NCT03145155
|Contact: Moe Moe Thandar, MHSfirstname.lastname@example.org|
|Contact: Junko Kiriya, PhDemail@example.com|
|Rural Health Centers||Recruiting|
|Pantanaw township, Wakema township, Ingapu township, Ayeyarwaddy, Japan, 182-0025|
|Contact: Moe Moe Thandar firstname.lastname@example.org|
|Principal Investigator:||Moe Moe Thandar||Tokyo University|