Evaluation of the Maternal and Child Survival Program (MCSP) in Mozambique Using Mixed Methods

February 25, 2019 updated by: Jhpiego
This study evaluates changes in knowledge, attitudes, practices and coverage of key reproductive, maternal, newborn, and child health (RMNCH) areas, including malaria, family planning (FP), nutrition, water, sanitation and hygiene (WASH), and gender equity among the population in Nampula and Sofala provinces targeted by the Maternal and Child Survival Program (MCSP) in Mozambique.

Study Overview

Detailed Description

The specific objectives of the study are to:

  1. Assess changes in knowledge, attitudes, practices and coverage (KAPC) of high-impact interventions related to MNCH (antenatal care, delivery, post-partum/natal care, and sick child care), immunization, family planning and reproductive health, nutrition, WASH and malaria among mothers and fathers of children age 0-23 months in MCSP supported areas;
  2. Evaluate the effectiveness of male engagement interventions that encourage couples communication at increasing antenatal care (ANC) attendance, joint birth preparedness and complication readiness (BPCR) plans, institutional birth, and use of modern FP;
  3. Determine the feasibility and acceptability of male engagement interventions on RMNCH services for clients and providers;
  4. Explore how decisions between couples are made and what may influence their decisions about seeking RMNCH services; and
  5. Explore the experiences of women who were referred to a health facility for themselves or their child for obstetric, newborn or child health complications, and examine the factors contributing to whether and how those referrals were completed in Nampula Province.

This study is a final program evaluation that will use a mixed methods approach, including both quantitative and qualitative data collection.

Quantitative data will be collected through a cross-sectional KAPC household survey of mothers and fathers of children age 0-23 months, replicating the same KAPC questionnaire that was conducted at baseline in 2016 in the same geographic areas. Questions were harmonized with the DHS and MICS where appropriate. Findings from the endline KAPC survey will be compared to findings from the baseline survey to assess changes over time in the primary outcomes of interest.

Qualitative data will be collected through focus group discussions (FGDs) and in-depth interviews (IDIs) with clients (mothers and fathers of children age 0-23 months) and health providers in MCSP-supported areas. The qualitative component will be conducted to help us gain a more in-depth understanding of the influence of male engagement interventions on couples' decision-making and care-seeking related to RMNCH as well as the barriers and facilitators that affected the experience of identified women who were referred to health facilities for obstetric or newborn complications. We will explore both client and provider experiences with gender-equitable male engagement practices, as well as individual client referral narratives related to obstetric or newborn complications.

Study Type

Interventional

Enrollment (Actual)

2767

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Nampula
      • Angoche, Nampula, Mozambique
        • Angoche District, Community Setting
      • Meconta, Nampula, Mozambique
        • Meconta District, Community Setting
      • Mecuburi, Nampula, Mozambique
        • Mecuburi District, Community Setting
      • Moma, Nampula, Mozambique
        • Moma District, Community Setting
      • Monapo, Nampula, Mozambique
        • Monapo District, Community Setting
      • Mossuril, Nampula, Mozambique
        • Mossuril District, Community Setting
      • Nacala, Nampula, Mozambique
        • Centro de Saude Ontupaia
      • Nacala, Nampula, Mozambique
        • Centro de Saude Quissinmanjulo
      • Nacala, Nampula, Mozambique
        • Nacala Porto District, Community Setting
      • Namapa-erati, Nampula, Mozambique
        • Erati District, Community Setting
      • Ribaue, Nampula, Mozambique
        • Centro de Saude Iapala Sede
      • Ribaue, Nampula, Mozambique
        • Hospital Rural de Ribaue
      • Ribaue, Nampula, Mozambique
        • Ribaue District, Community Setting
    • Sofala
      • Beira, Sofala, Mozambique
        • Beira City, Community Setting
      • Buzi, Sofala, Mozambique
        • Buzi District, Community Setting
      • Buzi, Sofala, Mozambique
        • Centro de Saude Ampara
      • Buzi, Sofala, Mozambique
        • Centro de Saude Bandua
      • Dondo, Sofala, Mozambique
        • Dondo District, Community Setting
      • Nhamatanda, Sofala, Mozambique
        • Nhamatanda District, Community Setting
      • Nhamatanda, Sofala, Mozambique
        • Centro de Saude Metuchira
      • Nhamatanda, Sofala, Mozambique
        • Hospital Rural de Nhamatanda

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

15 years to 49 years (ADULT, CHILD)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria (KAPC survey):

  • Women 15 years and older who have had a live birth in the 2 years preceding the survey and the child is living at the time of the interview
  • Male partners (age 18 and older) of women 15 years and older who have had a live birth in the 2 years preceding the survey and the child is living at the time of the interview

Exclusion Criteria (KAPC survey): Women 15-17 years without parent permission to participate in study

Inclusion Criteria (Referral narrative interviews): Women who: a) delivered in the last 12 months who experienced obstetric complications; b) whose newborn experienced complications in the last year; c) whose child 0-59 months experienced an illness in the last year

Inclusion Criteria (Provider interviews):

  • Facility managers working in selected primary health care centers
  • Health care workers who provide RMNCH services in MCSP-supported facility in one of these six areas: ANC, maternity, postnatal care, FP, sick child, or well-child

Exclusion Criteria (Provider interviews): Has been working in the facility for < 6 months

Inclusion Criteria (Male engagement FGDs):

  • Women 18-49 years of age who delivered in the last 12 months
  • Male partner (age 18 and older) of a woman 18-49 years of age who delivered in the last 12 months
  • Participated in a community dialogue

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: PREVENTION
  • Allocation: NA
  • Interventional Model: SINGLE_GROUP
  • Masking: NONE

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
EXPERIMENTAL: MCSP package of interventions
MCSP package of interventions for health promotion and provision of RMNCH services
Implementation of quality, high-impact interventions at institutional and community levels to increase access to and utilization of RMNCH services

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Institutional delivery rate
Time Frame: 2 years
Percentage of last-born children age 0-23 months who were born in a health facility
2 years
Percentage of pregnant women who had four or more ANC visits
Time Frame: 2 years
Percentage of mothers of children age 0-23 months who had four or more antenatal care visits while pregnant with their youngest child
2 years
Percentage of children under 2 years of age who received Penta 1 vaccination but did not receive Penta 3 (Drop out rate)
Time Frame: 2 years
Percentage of children age 12-23 months who received a Penta 1 vaccination but did not receive a Penta 3 vaccination according to or card verified at the time of the survey
2 years
Percentage of mothers who made birth preparations before giving birth
Time Frame: 2 years
Percentage of mothers of children age 0-23 months who made birth preparations before the birth of their youngest child
2 years

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Percentage of women who have discussed FP use with her partner
Time Frame: 2 years
Percentage of women of reproductive age who have discussed with her partner whether to use a FP method
2 years
Percent of infants under 6 months of age who are exclusively breastfed
Time Frame: 2 years
Percentage of infants 0-5 months of age who are fed exclusively with breast milk
2 years

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Connie Lee, MPH, MIA, Jhpiego

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (ACTUAL)

November 22, 2018

Primary Completion (ACTUAL)

December 22, 2018

Study Completion (ACTUAL)

December 22, 2018

Study Registration Dates

First Submitted

December 11, 2018

First Submitted That Met QC Criteria

December 11, 2018

First Posted (ACTUAL)

December 13, 2018

Study Record Updates

Last Update Posted (ACTUAL)

February 27, 2019

Last Update Submitted That Met QC Criteria

February 25, 2019

Last Verified

February 1, 2019

More Information

Terms related to this study

Other Study ID Numbers

  • IRB 8902

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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.

Clinical Trials on Knowledge, Attitudes, Practice

Clinical Trials on Health promotion and provision of RMNCH services

3
Subscribe