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© Tripathy et al; licensee BioMed Central Ltd. 2011. This work is published under http://creativecommons.org/licenses/by/2.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Background

Around a quarter of the world's neonatal and maternal deaths occur in India. Morbidity and mortality are highest in rural areas and among the poorest wealth quintiles. Few interventions to improve maternal and newborn health outcomes with government-mandated community health workers have been rigorously evaluated at scale in this setting.

The study aims to assess the impact of a community mobilisation intervention with women's groups facilitated by ASHAs to improve maternal and newborn health outcomes among rural tribal communities of Jharkhand and Orissa.

Methods/design

The study is a cluster-randomised controlled trial and will be implemented in five districts, three in Jharkhand and two in Orissa. The unit of randomisation is a rural cluster of approximately 5000 population. We identified villages within rural, tribal areas of five districts, approached them for participation in the study and enrolled them into 30 clusters, with approximately 10 ASHAs per cluster. Within each district, 6 clusters were randomly allocated to receive the community intervention or to the control group, resulting in 15 intervention and 15 control clusters. Randomisation was carried out in the presence of local stakeholders who selected the cluster numbers and allocated them to intervention or control using a pre-generated random number sequence. The intervention is a participatory learning and action cycle where ASHAs support community women's groups through a four-phase process in which they identify and prioritise local maternal and newborn health problems, implement strategies to address these and evaluate the result. The cycle is designed to fit with the ASHAs' mandate to mobilise communities for health and to complement their other tasks, including increasing institutional delivery rates and providing home visits to mothers and newborns. The trial's primary endpoint is neonatal mortality during 24 months of intervention. Additional endpoints include home care practices and health care-seeking in the antenatal, delivery and postnatal period. The impact of the intervention will be measured through a prospective surveillance system implemented by the project team, through which mothers will be interviewed around six weeks after delivery. Cost data and qualitative data are collected for cost-effectiveness and process evaluations.

Study registration

ISRCTN: ISRCTN31567106

Details

Title
Community mobilisation with women's groups facilitated by Accredited Social Health Activists (ASHAs) to improve maternal and newborn health in underserved areas of Jharkhand and Orissa: study protocol for a cluster-randomised controlled trial
Author
Tripathy, Prasanta 1 ; Nair, Nirmala 1 ; Mahapatra, Rajendra 1 ; Rath, Shibanand 1 ; Gope, Raj Kumar 1 ; Rath, Suchitra 1 ; Bajpai, Aparna 1 ; Singh, Vijay 1 ; Nath, Vikash 1 ; Ali, Sarfraz 1 ; Kundu, Alok Kumar 1 ; Choudhury, Dibarkar 1 ; Ghosh, Sanjib 1 ; Sarbani, Swati 1 ; Sinha, Rajesh 1 ; Pagel, Christina 2 ; Costello, Anthony 3 ; Houweling, Tanja AJ 3 ; Prost, Audrey 3 

 Ekjut, Jharkhand, India (GRID:grid.452480.f) 
 University College London, Clinical Operational Research Unit, Department of Mathematics, London, UK (GRID:grid.83440.3b) (ISNI:0000000121901201) 
 Institute of Child Health, UCL Centre for International Health and Development, London, UK (GRID:grid.83440.3b) (ISNI:0000000121901201) 
Pages
182
Publication year
2011
Publication date
Dec 2011
Publisher
BioMed Central
e-ISSN
17456215
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2794946344
Copyright
© Tripathy et al; licensee BioMed Central Ltd. 2011. This work is published under http://creativecommons.org/licenses/by/2.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.