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Waiting Time. Wasting Time

30 avril 2018 mis à jour par: Margaret McConnell, Harvard School of Public Health (HSPH)

Waiting Time. Wasting Time: A Randomized Control Trial to Investigate the Health Impacts of Improving the Quality of Antenatal Care in Mozambique

Our study's principle purpose is to determine whether decreasing waiting time before being seen for antenatal care increases demand for and use of antenatal care services in Mozambique.

Aperçu de l'étude

Statut

Complété

Les conditions

Intervention / Traitement

Description détaillée

This protocol describes a pilot study that will test the impact of a scheduling intervention intended to reduce waiting times for antenatal care. The study will include one intervention health clinic and one control clinic in Maputo, Mozambique. In the intervention facility women attending antenatal care will be informed that if they return at their scheduled date and time they will be seen within one hour by clinic staff rather than having to wait for an indefinite amount of time before being seen for care. Appointment cards will be clipped into ANC cards, which collect routine health data and are kept by women at the end of their ANC visit. Health facility staff will be trained to identify women who return at their scheduled time and to manage patient flow such that scheduled women are received quickly. After the start date of the intervention, all women attending ANC at the health facility will be provided a scheduled return date and time window. Baseline and endline exit interview surveys will be conducted in both intervention and control facilities to compare changes in waiting time, number of ANC visits, and provider satisfaction over the course the study period between clinics.

Type d'étude

Interventionnel

Inscription (Réel)

597

Phase

  • N'est pas applicable

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans et plus (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Oui

Sexes éligibles pour l'étude

Femelle

La description

Inclusion Criteria:

Inclusion criteria for individual study participants enrolled after delivery:

1. Women who delivered at the health facility during the weeks of recruitment

Inclusion criteria for women whose waiting time is measured:

1. Women at the health facility to seek care for antenatal care or another reproductive health service (anticipate total enrollment of 800 women)

Inclusion criteria for the health care provider survey is that the provider

  1. Have worked in the health facility for at least 6 months
  2. The health care worker provides ANC as part of their routine duties (anticipate total enrollment of 4 health care workers)

Exclusion Criteria:

Exclusion criteria for individual study participants enrolled after delivery:

  1. Women under 18 years of age will be excluded
  2. Women whose babies die during labor or childbirth from the delivery exit interviews

There are no exclusion criteria for the sample of women whose waiting time will be measured There are no exclusion criteria for the health care provider survey

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Recherche sur les services de santé
  • Répartition: Non randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Aucune intervention: Contrôler
Expérimental: Scheduling Intervention
Pre-natal visit scheduling
This intervention will include a scheduled date and time for prenatal care follow-up visits. Women in the intervention group seeking care for their first ANC appointment will be offered several appointment slots on their return date by the nurse providing their first ANC visit. Women will be able select among the time options and will be provided an appointment card with their scheduled date and time. Staff will limit the number of scheduled women per hour by maintaining an appointment book. Clinic staff will be trained to differentiate between women returning for a scheduled visit from first prenatal visits, emergencies, and unscheduled return visits. First visits and emergencies will be seen during the first 2 hours after clinic opening and unscheduled women will be seen during a one-hour time slot midday. When women return on their date, they will be seen within one hour of their appointment time by clinic staff.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Délai
Change in percent of women completing at least 4 prenatal care visits before and after intervention
Délai: During most recent pregnancy, as reported in an exit survey conducted at discharge from delivery at baseline and six months after the start of the scheduling intervention
During most recent pregnancy, as reported in an exit survey conducted at discharge from delivery at baseline and six months after the start of the scheduling intervention
Change in average waiting time before being seen for prenatal care before and after intervention
Délai: Measured for 4 weeks at baseline before the start of the intervention, and for 4 weeks, 3 months after the start of the intervention
Measured for 4 weeks at baseline before the start of the intervention, and for 4 weeks, 3 months after the start of the intervention

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Change in nurses satisfaction with their job (1-5 scale)
Délai: Measured before the start of the intervention, and 6 months after the start of the intervention
Measured before the start of the intervention, and 6 months after the start of the intervention
Change in proportion of key ANC services respondent reports receiving at most recent prenatal care visit, 9 possible services measured in exit survey at discharge from delivery.
Délai: Measured at baseline and 6 months after the start of the intervention

9 key services include:

  • IPTP dose provided, measured by self-report
  • Delivery plan discussed, measured by self-report
  • Hemoglobin test measured by patient report of having had their blood drawn
  • Recommendations for family planning and breast feeding provided, measured by self-report
  • Detection of breech measured by report of the provider palpating the tummy
  • Blood pressure
  • Measurement of uterine height
  • Urine test
  • Recommendation for what to do in emergencies
Measured at baseline and 6 months after the start of the intervention

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Publications et liens utiles

La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

1 octobre 2016

Achèvement primaire (Réel)

1 juillet 2017

Achèvement de l'étude (Réel)

1 juillet 2017

Dates d'inscription aux études

Première soumission

17 octobre 2016

Première soumission répondant aux critères de contrôle qualité

18 octobre 2016

Première publication (Estimation)

19 octobre 2016

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

2 mai 2018

Dernière mise à jour soumise répondant aux critères de contrôle qualité

30 avril 2018

Dernière vérification

1 avril 2018

Plus d'information

Termes liés à cette étude

Autres numéros d'identification d'étude

  • 0344

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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