Are stage-based health information messages effective and good value for money in improving maternal newborn and child health outcomes in India? Protocol for an individually randomized controlled trial

Trials

Diwakar Mohan¹  Smisha Agarwal¹  Neha Shah¹  Alain Labrique¹  Kerry Scott¹  Amnesty LeFevre²  Anna Godfrey³  Sara Chamberlain⁴  Diva Dhar⁵  Aditya Singh⁶  Rakesh Chandra⁶  Aarushi Bhatnagar⁶ 

[1] 0000 0001 2171 9311, grid.21107.35, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, USA;0000 0004 1937 1151, grid.7836.a, Health Intelligence Initiative, Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa;0000 0001 2171 9311, grid.21107.35, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, USA;000000009830888X, grid.28371.3f, BBC Media Action, Ibex House, 42-47 Minories, EC3N 1DY, London, England;BBC Media Action, E-21, Market Lane, Hauz Khas, 110016, New Delhi, Delhi, India;Bill and Melinda Gates Foundation, Capital Court, Munirka, 110067, New Delhi, India;Oxford Policy Management, 4/6 First Floor, Siri Fort Institutional Area, 110049, New Delhi, India;

关键词: Mobile health;    mHealth;    Maternal messaging;    India;    Pregnant women;   

DOI  :  10.1186/s13063-019-3369-5

来源: publisher

【 摘 要 】

BackgroundEvidence is limited on the effectiveness of mobile health programs which provide stage-based health information messages to pregnant and postpartum women. Kilkari is an outbound service that delivers weekly, stage-based audio messages about pregnancy, childbirth, and childcare directly to families in 13 states across India on their mobile phones. In this protocol we outline methods for measuring the effectiveness and cost-effectiveness of Kilkari.MethodsThe study is an individually randomized controlled trial (iRCT) with a parallel, partially concurrent, and unblinded design. Five thousand pregnant women will be enrolled from four districts of Madhya Pradesh and randomized to an intervention or control arm. The women in the intervention arm will receive Kilkari messages while the control group will not receive any Kilkari messages as part of the study. Women in both arms will be followed from enrollment in the second and early third trimesters of pregnancy until one year after delivery. Differences in primary outcomes across study arms including early and exclusive breastfeeding and the adoption of modern contraception at 1 year postpartum will be assessed using intention to treat methodology. Surveys will be administered at baseline and endline containing modules on phone ownership, geographical and demographic characteristics, knowledge, practices, respectful maternity care, and coverage for antenatal care, delivery, and postnatal care. In-depth interviews and focus group discussions will be carried out to understand user perceptions of Kilkari, and more broadly, experiences providing phone numbers and personal health information to health care providers. Costs and consequences will be estimated from a societal perspective for the 2018–2019 analytic time horizon.DiscussionKilkari is the largest maternal messaging program, in terms of absolute numbers, currently being implemented globally. Evaluations of similar initiatives elsewhere have been small in scale and focused on summative outcomes, presenting limited evidence on individual exposure to content. Drawing upon system-generated data, we explore linkages between successful receipt of calls, user engagement with calls, and reported outcomes. This is the first study of its kind in India and is anticipated to provide the most robust and comprehensive evidence to date on maternal messaging programs globally.Trial registrationClinicaltrials.gov, 90075552, NCT03576157. Registered on 22 June 2018.

【 授权许可】

CC BY