Impact of universal home visits on maternal and infant outcomes in Bauchi state, Nigeria: protocol of a cluster randomized controlled trial
Abstract Background Maternal mortality in Nigeria is one of the highest in the world. Access to antenatal care is limited and the quality of services is poor in much of the country. Previous research in Bauchi State found associations between maternal morbidity and domestic violence, heavy work in p...
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| Format: | Article |
| Language: | English |
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BMC
2018-07-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12913-018-3319-z |
| _version_ | 1811231811231023104 |
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| author | Anne Cockcroft Khalid Omer Yagana Gidado Adamu Ibrahim Gamawa Neil Andersson |
| author_facet | Anne Cockcroft Khalid Omer Yagana Gidado Adamu Ibrahim Gamawa Neil Andersson |
| author_sort | Anne Cockcroft |
| collection | DOAJ |
| description | Abstract Background Maternal mortality in Nigeria is one of the highest in the world. Access to antenatal care is limited and the quality of services is poor in much of the country. Previous research in Bauchi State found associations between maternal morbidity and domestic violence, heavy work in pregnancy, lack of knowledge about danger signs, and lack of spousal communication about pregnancy and childbirth. This cluster randomized controlled stepped-wedge trial will test the impact of universal home visits to pregnant women and their partners, and the added value of video edutainment. Methods The trial will take place in six wards of Toro Local Government Area in Bauchi State, Nigeria, randomly allocated into three waves of two wards each. Home visits will begin in wave 1 wards immediately; in wave 2 wards after one year; and in wave 3 wards after a further year. In each wave, one ward, randomly allocated, will receive video edutainment during the home visits. Female home visitors will contact all households in their catchment areas of about 300 households, register all pregnant women, and visit them every two months during pregnancy, after delivery and one year later. They will use android handsets to collect information on pregnancy progress, send this to a central server, and discuss with the women the evidence about household factors associated with higher maternal risks, using video clips in the edutainment wards. Male home visitors will contact the partners of the pregnant women and discuss with them the same evidence. We will compare outcomes between wave 1 and wave 2 wards at about one year, between wave 2 and wave 3 wards at about two years, and finally between wards with and without added edutainment. Primary outcomes will be complications in pregnancy and delivery, and child health at one year. Secondary outcomes include knowledge and attitudes, use of health services, knowledge of danger signs, and household care of pregnant women. Discussion Demonstrating an impact of home visits and understanding potential mechanisms could have important implications for reducing maternal morbidity and mortality in other settings with poor access to quality antenatal care services. Trial registration Registration number: ISRCTN82954580. Registry: ISRCTN. Date of registration: 11 August 2017. Retrospectively registered. |
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| format | Article |
| id | doaj.art-b4369bcf2c944ddeb9ffeaeedc8cd3c1 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-04-12T10:51:22Z |
| publishDate | 2018-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-b4369bcf2c944ddeb9ffeaeedc8cd3c12022-12-22T03:36:14ZengBMCBMC Health Services Research1472-69632018-07-0118111110.1186/s12913-018-3319-zImpact of universal home visits on maternal and infant outcomes in Bauchi state, Nigeria: protocol of a cluster randomized controlled trialAnne Cockcroft0Khalid Omer1Yagana Gidado2Adamu Ibrahim Gamawa3Neil Andersson4CIET/PRAM, Department of Family Medicine, McGill UniversityCIET in Nigeria, Federal Low Cost, Near Police StationFederation of Muslim Women Association of Nigeria (FOMWAN), Bauchi Chapter, FOMWAN Nursery/Pri/Sec. SchoolsBauchi State Primary Health Care Development Agency, Ministry of HealthCIET/PRAM, Department of Family Medicine, McGill UniversityAbstract Background Maternal mortality in Nigeria is one of the highest in the world. Access to antenatal care is limited and the quality of services is poor in much of the country. Previous research in Bauchi State found associations between maternal morbidity and domestic violence, heavy work in pregnancy, lack of knowledge about danger signs, and lack of spousal communication about pregnancy and childbirth. This cluster randomized controlled stepped-wedge trial will test the impact of universal home visits to pregnant women and their partners, and the added value of video edutainment. Methods The trial will take place in six wards of Toro Local Government Area in Bauchi State, Nigeria, randomly allocated into three waves of two wards each. Home visits will begin in wave 1 wards immediately; in wave 2 wards after one year; and in wave 3 wards after a further year. In each wave, one ward, randomly allocated, will receive video edutainment during the home visits. Female home visitors will contact all households in their catchment areas of about 300 households, register all pregnant women, and visit them every two months during pregnancy, after delivery and one year later. They will use android handsets to collect information on pregnancy progress, send this to a central server, and discuss with the women the evidence about household factors associated with higher maternal risks, using video clips in the edutainment wards. Male home visitors will contact the partners of the pregnant women and discuss with them the same evidence. We will compare outcomes between wave 1 and wave 2 wards at about one year, between wave 2 and wave 3 wards at about two years, and finally between wards with and without added edutainment. Primary outcomes will be complications in pregnancy and delivery, and child health at one year. Secondary outcomes include knowledge and attitudes, use of health services, knowledge of danger signs, and household care of pregnant women. Discussion Demonstrating an impact of home visits and understanding potential mechanisms could have important implications for reducing maternal morbidity and mortality in other settings with poor access to quality antenatal care services. Trial registration Registration number: ISRCTN82954580. Registry: ISRCTN. Date of registration: 11 August 2017. Retrospectively registered.http://link.springer.com/article/10.1186/s12913-018-3319-zHome visitsMaternal and newborn healthNigeriaRandomized controlled trialStepped-wedge designEdutainment |
| spellingShingle | Anne Cockcroft Khalid Omer Yagana Gidado Adamu Ibrahim Gamawa Neil Andersson Impact of universal home visits on maternal and infant outcomes in Bauchi state, Nigeria: protocol of a cluster randomized controlled trial BMC Health Services Research Home visits Maternal and newborn health Nigeria Randomized controlled trial Stepped-wedge design Edutainment |
| title | Impact of universal home visits on maternal and infant outcomes in Bauchi state, Nigeria: protocol of a cluster randomized controlled trial |
| title_full | Impact of universal home visits on maternal and infant outcomes in Bauchi state, Nigeria: protocol of a cluster randomized controlled trial |
| title_fullStr | Impact of universal home visits on maternal and infant outcomes in Bauchi state, Nigeria: protocol of a cluster randomized controlled trial |
| title_full_unstemmed | Impact of universal home visits on maternal and infant outcomes in Bauchi state, Nigeria: protocol of a cluster randomized controlled trial |
| title_short | Impact of universal home visits on maternal and infant outcomes in Bauchi state, Nigeria: protocol of a cluster randomized controlled trial |
| title_sort | impact of universal home visits on maternal and infant outcomes in bauchi state nigeria protocol of a cluster randomized controlled trial |
| topic | Home visits Maternal and newborn health Nigeria Randomized controlled trial Stepped-wedge design Edutainment |
| url | http://link.springer.com/article/10.1186/s12913-018-3319-z |
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