- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05929586
Digital Data Linkage and Scheduling to Track Pregnancy With or Without Community Data Use to Increase Antenatal Clinic Uptake in Western Kenya. (C-it-DU-it)
A Pragmatic Open-label, Community-based, Cluster Randomised Controlled Superiority Trial to Evaluate the Efficacy and Cost-effectiveness of Digital Data Linkage and Scheduling ('C-it') With or Without Community Data Use ('DU-it') to Increase Antenatal Clinic Uptake in Western Kenya.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Hellen C Barsosio, MD
- Phone Number: +254724464507
- Email: hbarsosio@kemri.go.ke
Study Contact Backup
- Name: Lilian Otiso, MD
- Phone Number: +254722293139
- Email: lilian.otiso@lvcthealth.org
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Pregnant women of all ages willing to participate
- Written informed consent
- A resident of the study area (catchment area) for the duration of the pregnancy
- Delivered and still within the 6-week post-partum period.
Exclusion Criteria:
- Currently enrolled in another interventional study targeting pregnant women
- Outside the 6-week post-partum period.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Health Services Research
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
No Intervention: Digital data linkage and scheduling ('C-it'): The "C-it" enhanced standard of care
Linking facility to community digital data via linkage-app: Data between electronic Community Health Information System (eCHIS) and facility-based Kenya Electronic Medical Record (Kenya EMR) do not link.
We do not have an existing digital data linkage module or app to track successful pregnancy referrals or allow the facility staff to view community contacts and vice versa.
We will engage with national and county teams and software developers to build a digital data linkage module, linking eCHIS and Kenya EMR Maternal and Child Health (MCH) module.
|
|
Experimental: The combined "C-it DU-it" intervention: community data use for ANC
Combining "C-it" and work improvement teams (WITs) for community data use: We will establish and train integrated WITs in intervention sites consisting of community health members, health facility staff and community members and train them on how they will use linkage-app. The resultant combined "C-it DU-it" intervention has three building blocks: We make the following assumptions about the building blocks at the bottom of figure 1.
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Combining data linkage ("C-it") with work improvement teams for community data use ("DU-it") to improve antenatal clinic uptake.
Our short name C-it DU-it (pronounced "see-it; do-it") is an acronym intended to convey 'seeing' linked data (C-it) and 'doing' or acting on the data (DU-it)
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Increasing antenatal clinic uptake
Time Frame: 14 months
|
The proportion of women having at least eight ANC contacts during the antenatal period, defined as either a scheduled ANC visit in the facility or a scheduled ANC contact with a CHV in the community assessed at birth (or within the first 6-8 weeks for home births) using the ANC cards.
|
14 months
|
Estimate socioeconomic impact and access to social protection
Time Frame: 14 months
|
Defined as the proportion of women using financial coping strategies and their frequency and distribution
|
14 months
|
Estimate the costs to pregnant women and their households
Time Frame: 14 months
|
Absolute costs to the pregnant woman and their household and the costs as a proportion of the pregnant woman and their household's monthly income or expenditure/consumption will be calculated for the following variables:
|
14 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The proportion of women having at least four scheduled ANC visits in the facility
Time Frame: 14 months
|
assessed at birth (or within the first 6-8 weeks after birth for home births) using the ANC cards.
|
14 months
|
The proportion of women having at least eight scheduled ANC visits in the facility
Time Frame: 14 months
|
assessed at birth (or within the first 6-8 weeks after birth for home births) using the ANC cards.
|
14 months
|
The frequency (count) of scheduled ANC visits
Time Frame: 14 months
|
assessed at birth (or within the first 6-8 weeks after birth for home births) using the ANC cards.
|
14 months
|
The frequency (count) of of ANC visits in the community
Time Frame: 14 months
|
assessed at birth (or within the first 6-8 weeks after birth for home births) using the ANC cards.
|
14 months
|
Early antenatal clinic attendance
Time Frame: 14 months
|
The proportion of women with a first ANC contact before 16 weeks gestation.
|
14 months
|
Quality of antenatal care
Time Frame: 14 months
|
|
14 months
|
Uptake of skilled birth attendance.
Time Frame: 14 months
|
The proportion of women who had a skilled birth attendance.
|
14 months
|
Reducing the risk of adverse pregnancy outcomes.
Time Frame: 14 months
|
The proportion of women with adverse pregnancy outcomes- defined as a composite of foetal loss (stillbirth or spontaneous miscarriage), low birth weight or neonatal mortality)
|
14 months
|
prevalence of catastrophic health expenditure (CHE) of accessing ANC care with "C-it" enhanced standard of care
Time Frame: 14 months
|
CHE prevalence at two World Health Organization-defined thresholds: out-of-pocket medical costs of more than 10% of a patient household's total monthly expenditure/consumption (10%-threshold); and out-of-pocket medical costs of more than 40% of a patient household's monthly capacity to pay (non-food/housing/utilities expenditure/consumption) • A sensitivity analysis of the proportion of women's households incurring CHE due to pregnancy and ANC visits using varying additional recognised calculations and thresholds including, as per WHO Tuberculosis Patient Cost Survey methodology, the addition of non-medical out-of-pocket costs and lost income in the numerator |
14 months
|
Cost-effectiveness of "C-it" and "C-it DU-it" intervention
Time Frame: 14 months
|
Incremental cost-effectiveness ratios (ICERs) compared across trial arms
|
14 months
|
Assess equity of access to ANC and "C-it" and "C-it DU-it" intervention.
Time Frame: 14 months
|
Equity of access to ANC and the interventions will be evaluated by exploratory distributional (or "extended") cost-effectiveness analysis of the intervention across the following sub-groups: poverty quintiles, age groups including adolescents vs adults, study sites, HIV status, and by eligibility for health insurance including NHIF and Linda Mama.
|
14 months
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Improving uptake of four ANC tests.
Time Frame: 14 months
|
The proportion of women receiving testing and management of all four common conditions in pregnancy (HIV, syphilis, malaria, anaemia).
|
14 months
|
Improving uptake of HIV prevention services.
Time Frame: 14 months
|
The proportion of HIV-negative women receiving testing and management for HIV in the 3rd trimester or at delivery. The proportion of HIV-exposed infants with negative HIV PCR DNA tests at 6-8 weeks. |
14 months
|
Collaborators and Investigators
Investigators
- Principal Investigator: Miriam Taegtmeyer, PhD, Liverpool School of Tropical Medicine
- Principal Investigator: Tom Wingfield, PhD, Liverpool School of Tropical Medicine
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- 22-073
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
- ANALYTIC_CODE
- CSR
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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