Trial Outcomes & Findings for Incentives for Postnatal Care Demand (NCT NCT02936869)
NCT ID: NCT02936869
Last Updated: 2019-07-24
Results Overview
The proportion of delivery clients that are successfully referred by the traditional birth attendant for postnatal care within 48 hours of delivery. For each delivery client that the traditional birth attendant reported, we visited at least three days after delivery to ascertain if they had been asked to visit the postnatal clinic, clarify if they had visited the clinic within 48 hours of delivery, and what care they had received (if yes). The team visited traditional birth attendants every two weeks to identify new clients. Where a new client was not up to three days post-delivery, the interview was postponed until the next visit by the team to the community. This occurred repeatedly, over a five-month frame.
COMPLETED
NA
207 participants
Within 48 hours of delivery
2019-07-24
Participant Flow
Participants were recruited from the community within 128 wards in Ebonyi State in August 2016.
Of the 269 TBAs identified through community leaders and facility heads that met the inclusion criteria and were recruited, 20 declined to participate and 27 could not be located at the given addresses.
Participant milestones
| Measure |
Control Arm
Traditional birth attendants will receive an offer of two-weekly payouts per reported delivery they take that is verified by client.
|
Referral Incentive Arm
Traditional birth attendants will receive an offer of two-weekly payouts per reported delivery they take that is verified by client.
Traditional birth attendants randomized to this arm will also receive an offer of two-weekly payouts per successful referral of delivery clients to postnatal care within 48 hours of delivery in a facility if verified.
Performance-based monetary incentives
|
|---|---|---|
|
Overall Study
STARTED
|
104
|
103
|
|
Overall Study
COMPLETED
|
102
|
98
|
|
Overall Study
NOT COMPLETED
|
2
|
5
|
Reasons for withdrawal
| Measure |
Control Arm
Traditional birth attendants will receive an offer of two-weekly payouts per reported delivery they take that is verified by client.
|
Referral Incentive Arm
Traditional birth attendants will receive an offer of two-weekly payouts per reported delivery they take that is verified by client.
Traditional birth attendants randomized to this arm will also receive an offer of two-weekly payouts per successful referral of delivery clients to postnatal care within 48 hours of delivery in a facility if verified.
Performance-based monetary incentives
|
|---|---|---|
|
Overall Study
Lost to Follow-up
|
1
|
3
|
|
Overall Study
Death
|
0
|
1
|
|
Overall Study
Legal Case
|
0
|
1
|
|
Overall Study
Protocol Violation
|
1
|
0
|
Baseline Characteristics
Incentives for Postnatal Care Demand
Baseline characteristics by cohort
| Measure |
Control Arm
n=104 Participants
Traditional birth attendants will receive an offer of two-weekly payouts per reported delivery they take that is verified by client.
|
Referral Incentive Arm
n=103 Participants
Traditional birth attendants will receive an offer of two-weekly payouts per reported delivery they take that is verified by client.
Traditional birth attendants randomized to this arm will also receive an offer of two-weekly payouts per successful referral of delivery clients to postnatal care within 48 hours of delivery in a facility if verified.
Performance-based monetary incentives
|
Total
n=207 Participants
Total of all reporting groups
|
|---|---|---|---|
|
Age, Continuous
|
51.42308 years
STANDARD_DEVIATION 19.67241 • n=99 Participants
|
44.75728 years
STANDARD_DEVIATION 16.23206 • n=107 Participants
|
48.10628 years
STANDARD_DEVIATION 18.30641 • n=206 Participants
|
|
Sex: Female, Male
Female
|
101 Participants
n=99 Participants
|
97 Participants
n=107 Participants
|
198 Participants
n=206 Participants
|
|
Sex: Female, Male
Male
|
3 Participants
n=99 Participants
|
6 Participants
n=107 Participants
|
9 Participants
n=206 Participants
|
|
Number of participants lacking formal education
|
47 Participants
n=99 Participants
|
40 Participants
n=107 Participants
|
87 Participants
n=206 Participants
|
|
Average income per pregnancy
|
1790.962 Naira
STANDARD_DEVIATION 1852.523 • n=99 Participants
|
2265.437 Naira
STANDARD_DEVIATION 2992.071 • n=107 Participants
|
2027.053 Naira
STANDARD_DEVIATION 2491.036 • n=206 Participants
|
|
Number of participants offering postnatal care
|
70 Participants
n=99 Participants
|
60 Participants
n=107 Participants
|
130 Participants
n=206 Participants
|
|
Monthly average of delivery clients
|
13.80769 clients
STANDARD_DEVIATION 97.70553 • n=99 Participants
|
9.553398 clients
STANDARD_DEVIATION 48.90622 • n=107 Participants
|
11.69082 clients
STANDARD_DEVIATION 77.21418 • n=206 Participants
|
|
Number of participants that are literate in English
|
44 Participants
n=99 Participants
|
47 Participants
n=107 Participants
|
91 Participants
n=206 Participants
|
|
Number of participants that are literate in non-English Language
|
26 Participants
n=99 Participants
|
29 Participants
n=107 Participants
|
55 Participants
n=206 Participants
|
|
Number of participants who are leaders of any association
|
30 Participants
n=99 Participants
|
46 Participants
n=107 Participants
|
76 Participants
n=206 Participants
|
|
Number of participants who are members of any association
|
88 Participants
n=99 Participants
|
89 Participants
n=107 Participants
|
177 Participants
n=206 Participants
|
|
Number of participants who are the main income earner in household
|
26 Participants
n=99 Participants
|
28 Participants
n=107 Participants
|
54 Participants
n=206 Participants
|
PRIMARY outcome
Timeframe: Within 48 hours of deliveryPopulation: The analysis did not include information from the 7 TBAs lost to follow-up.
The proportion of delivery clients that are successfully referred by the traditional birth attendant for postnatal care within 48 hours of delivery. For each delivery client that the traditional birth attendant reported, we visited at least three days after delivery to ascertain if they had been asked to visit the postnatal clinic, clarify if they had visited the clinic within 48 hours of delivery, and what care they had received (if yes). The team visited traditional birth attendants every two weeks to identify new clients. Where a new client was not up to three days post-delivery, the interview was postponed until the next visit by the team to the community. This occurred repeatedly, over a five-month frame.
Outcome measures
| Measure |
Control Arm
n=102 Participants
Traditional birth attendants will receive an offer of two-weekly payouts per reported delivery they take that is verified by client.
|
Referral Incentive Arm
n=98 Participants
Traditional birth attendants will receive an offer of two-weekly payouts per reported delivery they take that is verified by client.
Traditional birth attendants randomized to this arm will also receive an offer of two-weekly payouts per successful referral of delivery clients to postnatal care within 48 hours of delivery in a facility if verified.
Performance-based monetary incentives
|
|---|---|---|
|
Maternal Postnatal Care Referral
|
0.044 proportion of maternal clients referred
Interval -0.009 to 0.097
|
0.154 proportion of maternal clients referred
Interval 0.079 to 0.229
|
SECONDARY outcome
Timeframe: Within 48 hours of deliveryPopulation: The analysis did not include data from 7 TBAs lost to follow-up.
Proportion of neonates delivered by the traditional birth attendant that are successfully referred for postnatal care within 48 hours of delivery
Outcome measures
| Measure |
Control Arm
n=102 Participants
Traditional birth attendants will receive an offer of two-weekly payouts per reported delivery they take that is verified by client.
|
Referral Incentive Arm
n=98 Participants
Traditional birth attendants will receive an offer of two-weekly payouts per reported delivery they take that is verified by client.
Traditional birth attendants randomized to this arm will also receive an offer of two-weekly payouts per successful referral of delivery clients to postnatal care within 48 hours of delivery in a facility if verified.
Performance-based monetary incentives
|
|---|---|---|
|
Neonatal Postnatal Care Referral
|
0.032 proportion of neonates referred
Interval -0.015 to 0.079
|
0.126 proportion of neonates referred
Interval 0.059 to 0.193
|
Adverse Events
Control Arm
Referral Incentive Arm
Serious adverse events
Adverse event data not reported
Other adverse events
Adverse event data not reported
Additional Information
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place