Evaluating the Effects of SMS Text Messaging Support System Among Frontline Health Workers in Ghana

Summary

Introduction Maternal and neonatal mortality continue to be to be prominent public health issues in sub Saharan Africa including Ghana, with slow progress made towards attainment of Millennium Development Goals (MDG) 4 \& 5. Studies have identified poor quality of maternal and child healthcare as a major challenge to the prevention of neonatal and maternal deaths. Effective interventions are required to make significant inroads in these areas.

Objective To evaluate the effect of a SMS text messaging intervention to support clinical decision making by frontline health care professionals on neonatal and maternal mortality.

Methods We propose to conduct a randomized controlled trial in the Eastern region of Ghana, involving 8 intervention and 8 control districts. The intervention consists of text messaging of standard protocols for maternal and neonatal care to front line health care providers in the region. A total of 17,040 pregnant women who are receiving care (including antenatal, delivery and post-natal) at any of the hospitals in the selected districts in the region will be monitored through monthly aggregate data on outcome measures such as neonatal and maternal deaths from eclampsia, postpartum haemorrhage, puerperal sepsis, birth asphyxia, low birth weight and neonatal sepsis. Cord sepsis will also be included as neonatal sepsis for this study. Also, a quality of care assessment in four sampled districts to measure adherence to the safe motherhood protocol will be conducted. Stata software package.55 and MLwiN software version 2.2456 will be employed in data analysis. Descriptive analysis will be carried out to explore baseline characteristics of study groups while logistic regression will be applied to evaluate the effect of the intervention. A two-tailed statistical significant level of 0.05 will be used.

Expected outcome We hypothesize that the intervention will improve both maternal and neonatal service delivery and health outcomes in the intervention areas.

Conditions

• Maternal Death
• Neonatal Death
• Postpartum Haemorrhage
• Pre-eclampsia
• Eclampsia
• Pregnancy Induced Hypertension
• Puerperal Sepsis
• Asphyxia
• Neonatal Sepsis
• Neonatal Jaundice

Interventions

OTHER

Maternal and neonatal emergency protocols

Protocols for management of Maternal and Neonatal emergencies based on the Safe Motherhood protocol adopted by the Ghana Health Service to improve maternal and neonatal health

Sponsors & Collaborators

• Ghana Health Services

  collaborator OTHER_GOV

• University of Ghana

  collaborator OTHER

• Hannah Brown Amoakoh

  lead OTHER

Principal Investigators

• Irene Agyepong, MD DRPH PhD · Julius Center University of Utrecht

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

PARALLEL

Eligibility

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2015-08-10

Primary Completion

2017-02-09

Completion

2017-04-09

Countries

• Ghana

Study Locations