Antenatal High-Risk Pregnancy Intervention Bundle in Rural Nepal
Implementing and Evaluating an Antenatal High-Risk Pregnancy Intervention Bundle in Rural Nepal
The proposed study will assess and implement a comprehensive antenatal HRP screening and telehealth follow-up program in rural Nepal. The main questions it aims to answer are:
- To estimate the burden of HRPs using the existing Antenatal Risk-Score Checklist in rural Nepal
- Assess acceptability, feasibility, preliminary effectiveness, and implementation outcomes of the HRP bundle at the primary healthcare in Nepal
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Archana Shrestha, PhD
- Telefonnummer: +9779801002245
- E-mail: archana@kusms.edu.np
Undersøgelse Kontakt Backup
- Navn: Anju Ranjit, MD MPH
- Telefonnummer: 4153533400
- E-mail: anju.ranjit@ucsf.edu
Studiesteder
-
-
Bagmati
-
Melamchi, Bagmati, Nepal
- Melamchi Primary Health Care Center
-
Kontakt:
- Umang Raut (Medical Superintendent)
- Telefonnummer: +977 9860923221
- E-mail: melamchiphc@gmail.com
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Barn
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- all pregnant women above who are receiving antenatal care at Melamchi Primary Health Care Center
Exclusion Criteria:
- life-threatening maternal or fetal conditions requiring immediate tertiary-level care
- unable to provide informed consent due to cognitive or language barriers
- do not have access to a mobile phone for telehealth consultations.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Sundhedstjenesteforskning
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Ingen indgriben: Standard of Care
Usual prenatal care, including on-site consultation and visits from health facility staff
|
|
|
Aktiv komparator: High Risk Pregnancy (HRP) Bundle Intervention Arm
The intervention arm would include 1. identification of high-risk pregnancy 2. Teleconsultation with expert consultant 3. weekly call with patient navigator 4. training of health care provider for HRP care, and 5. visits in the weekly prenatal telehealth clinic
|
The intervention would include 1. identification of high-risk pregnancy 2. Teleconsultation with expert consultant 3. weekly call with patient navigator 4. training of health care provider for HRP care, and 5. visits in the weekly prenatal telehealth clinic
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Maternal Near Miss
Tidsramme: up to 60 days postpartum
|
life-threatening complication during pregnancy, childbirth, or within 42 days postpartum, but survives with appropriate medical intervention (We will use WHO criteria)
|
up to 60 days postpartum
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Neonatal death
Tidsramme: Up to 28 days after birth
|
Number of neonatal deaths, defined as death of a liveborn infant within the first 28 days of life
|
Up to 28 days after birth
|
|
Low Apgar Score at 5 Minutes
Tidsramme: At 5 minutes after birth
|
Number of infants with an Apgar score less than 7 at 5 minutes after birth
|
At 5 minutes after birth
|
|
Neonatal Intensive Care Unit Admission
Tidsramme: Up to 30 days after birth
|
Number of infants admitted to a neonatal intensive care unit
|
Up to 30 days after birth
|
|
Need for Mechanical Ventilation
Tidsramme: up to 30 days after birth
|
Number of infants requiring mechanical ventilation
|
up to 30 days after birth
|
|
Neonatal Respiratory Distress Syndrome
Tidsramme: Up to 30 days after birth
|
Number of infants diagnosed with respiratory distress syndrome
|
Up to 30 days after birth
|
|
Neonatal Hypoglycemia
Tidsramme: Up to 48 hours after birth
|
Number of infants with hypoglycemia, defined as less than 45 mg/dl
|
Up to 48 hours after birth
|
|
Low Birth Weight
Tidsramme: At birth
|
Number of infants with birth weight less than 2500 grams
|
At birth
|
|
Composite Adverse Neonatal Outcome
Tidsramme: up to 30 days after birth
|
Number of infants with at least one of the following: neonatal death, Apgar score less than 7 at 5 minutes, NICU admission, need for mechanical ventilation, respiratory distress syndrome, hypoglycemia
|
up to 30 days after birth
|
|
Antenatal Risk Screening Rate
Tidsramme: Up to 24 months
|
Proportion of pregnant women enrolled in the study who undergo antenatal risk screening using the Antenatal Risk-Score Checklist
|
Up to 24 months
|
|
Referral Rate
Tidsramme: Up to 24 months
|
Percentage of pregnant women referred to higher levels of care based on risks identified through antenatal risk screening
|
Up to 24 months
|
|
Telehealth Consultation Utilization Rate
Tidsramme: Up to 24 months
|
Proportion of pregnant women in the High Risk Pregnancy Bundle Intervention Arm who utilize at least 80% of their recommended telehealth consultations
|
Up to 24 months
|
Andre resultatmål
Andre resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Acceptability of Intervention Measure (AIM) Score
Tidsramme: up to 24 months
|
We will assess the acceptability of each intervention component (risk-screening scoring system, teleconsultation, weekly patient navigator calls, and provider training) using the mean total score and standard deviation (SD) of the Acceptability of Intervention Measure (AIM), administered at both the patient and provider level.
|
up to 24 months
|
|
Intervention Appropriateness Measure (IAM) Score
Tidsramme: Up to 24 months
|
We will assess the appropriateness of each intervention component (risk-screening scoring system, teleconsultation, weekly patient navigator calls, and provider training) using the mean total score and standard deviation (SD) of the Intervention Appropriateness Measure (IAM), administered at both the patient and provider level.
|
Up to 24 months
|
|
Feasibility of Intervention Measure (FIM) Score
Tidsramme: Up to 24 months
|
We will assess the feasibility of each intervention component (risk-screening scoring system, teleconsultation, weekly patient navigator calls, and provider training) using the mean total score and standard deviation (SD) of the Feasibility of Intervention Measure (FIM), administered at both the patient and provider level.
|
Up to 24 months
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Ledende efterforsker: Anju Ranjit, MD MPH, University of California, San Francisco
- Ledende efterforsker: Archana Shrestha, Kathmandu University School of Medicine/Dhulikhel Hospital
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- 26-46873
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
IPD-planbeskrivelse
IPD-delingstidsramme
IPD-delingsadgangskriterier
IPD-deling Understøttende informationstype
- STUDY_PROTOCOL
- SAP
- ICF
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
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