- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01345695
Bihar Evaluation of Social Franchising and Telemedicine (BEST)
Bihar Evaluation of Social Franchising and Telemedicine in India
Study Overview
Status
Conditions
Detailed Description
In 2011, World Health Partners (WHP) will launch a large social franchising program of healthcare delivery in Bihar, India, with funding from the Bill and Melinda Gates Foundation (BMGF). The WHP project is particularly innovative in integrating a social franchising delivery model with a telemedicine platform. Although social franchising models of delivery are becoming increasingly common, to our knowledge, none of these efforts has been rigorously evaluated.
COHESIVE-India plans to undertake an evaluation of the BMGF-financed WHP project. The overarching focus of the evaluation project (called Bihar Evaluation of Social Franchising and Telemedicine (BEST)) is to provide evidence on the performance and effectiveness of the WHP program. In addition to studying the overall impact and effectiveness of the social franchising and telemedicine program, the evaluation will estimate how the WHP model influences outcomes related to two target diseases of interest to BMGF: childhood diarrhea and childhood pneumonia.
The Evaluation Design The core objective of the evaluation is to estimate the causal impact of the WHP program on BMGF target disease outcomes as well as other indicators of its primary health care success. The key design feature of the evaluation is that it relies on the franchisee network model of the WHP program. The evaluation design involves identifying villages in Bihar that have asymmetric digital subscriber line (ADSL) connectivity where WHP is likely to find providers who would participate in the program. The areas surrounding these villages that form catchment areas for providers will be identified; 360 such areas will be randomly sampled from the list and divided into 180 treatment and 180 control areas for implementation of the WHP program.
The study also includes a detailed costing component to estimate the costs associated with the target diseases and the benefits from the program intervention. In doing so, the evaluation strategy addresses specific policy-relevant questions about sustainability, affordability, replicability, and future Government support for privately provided healthcare options in Bihar as well as in other parts of India.
In addition, COHESIVE-India, with funding from external sources also plans to conduct studies that will provide insights on how to improve the effectiveness of the WHP model, as well as its financial sustainability. These studies include the distribution of vouchers for WHP services to estimate household's willingness to pay for them, as well experiments on financial incentives to learn how to improve the performance of network providers.
This evaluation is closely aligned with the objectives of the Government of Bihar to reduce the burden of disease. Through a rigorous evaluation of the WHP program, this study will provide evidence on whether this model of rural health service delivery is efficient and whether it can be scaled up. The stated goals of the WHP program indicate the many potential health and economic benefits to the people of Bihar. The evaluation will provide an empirical and objective assessment of the impact of WHP's effort on quality of care available in rural areas (the program anticipates a significant improvement), increases in access to healthcare providers and improved drug supply, reductions in time lapse between onset of disease and optimal care, as well as reductions in unnecessary healthcare expenditures.
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Locations
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Bihar
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Patna, Bihar, India
- BEST
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Households with children age < 60 months
- Persons with tuberculosis or visceral leishmaniasis
- Rural private sector medical providers
Exclusion Criteria:
- Households without children
- Households with children aged > 60 months
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
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Treatment
Data collected on persons living in the catchment area for a WHP telemedicine center
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Control
Data collected on persons living in the catchment area where there is not a WHP telemedicine center
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Improvements in population based health outcomes
Time Frame: Baseline; 3 years
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Improvements in population based health outcomes in the treatment vs. the control areas
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Baseline; 3 years
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Improvements in population based health outcomes for childhood diarrhea
Time Frame: Baseline; 3 years
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Proportion of children with diarrhea in the last two weeks who were treated with zinc
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Baseline; 3 years
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Improvements in population based health outcomes for childhood pneumonia
Time Frame: Baseline; 3 years
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Proportion of children with suspected pneumonia in the past two weeks who received a full course of antibiotics (five days)
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Baseline; 3 years
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Cost-effectiveness of the service model
Time Frame: Baseline; 3 years
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Through micro-experiments, we hope to gain insights on how to improve the cost effectiveness of the WHP model, as well as evaluate its financial sustainability.
We will also evaluate whether the are overall improvements in the population level health indicators in the treatment vs. the control areas.
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Baseline; 3 years
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Manoj Mohanan, PhD, MPH, Duke University
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- Pro00027527
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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