A protocol for a pilot cluster randomized control trial of e-vouchers and mobile phone application to enhance access to maternal health services in Cameroon.

Cluster randomized control trials Family planning Feasibility Geographic information system Maternal mortality Pilot Qualitative research Reproductive health Vouchers mHealth

Journal

Pilot and feasibility studies
ISSN: 2055-5784
Titre abrégé: Pilot Feasibility Stud
Pays: England
ID NLM: 101676536

Informations de publication

Date de publication:
2020
Historique:
received: 05 03 2019
accepted: 20 03 2020
entrez: 22 4 2020
pubmed: 22 4 2020
medline: 22 4 2020
Statut: epublish

Résumé

Cameroon still has relatively high maternal mortality rate (MMR) of 596/100,000 live births. Approximately 40% of births are unattended by skilled healthcare personnel with high out-of-pocket expenditures. Poor resource allocation, poorly functioning referral systems, long trekking distances to health facilities, all of which lead to low rates of use of maternal health services. The aim of this pilot study is to explore perception and acceptability of mobile health (mhealth) and e-voucher and to determine the feasibility of conducting a large cluster randomized trial to determine the effects of combining e-vouchers and a mobile application compared with usual care in improving access to and use of maternal health services. This is a multimethod study that comprises two phases. The first phase is the development of the mobile phone app, which includes a qualitative formative study through in-depth key informant interviews and focus group discussions. The second phase is a cluster randomized control trial assessing the combination of e-vouchers and a mobile application compared with usual care in improving access to and use of maternal health services. Feasibility will be determined based on evaluating randomization, contamination, enrollment rate, complete follow up, compliance rate, success in matching data from different sources, and data completeness. Ethics approval has been granted, and the trial has been registered in the Pan-African Clinical Trials Registry. We will disseminate our findings through peer-reviewed manuscripts and conference presentations. Findings from this study will inform the design and conduct of a larger randomized trial. PACTR201808703097367. The trial on the Pan African Clinical Trials Registry.

Sections du résumé

BACKGROUND BACKGROUND
Cameroon still has relatively high maternal mortality rate (MMR) of 596/100,000 live births. Approximately 40% of births are unattended by skilled healthcare personnel with high out-of-pocket expenditures. Poor resource allocation, poorly functioning referral systems, long trekking distances to health facilities, all of which lead to low rates of use of maternal health services.
OBJECTIVES OBJECTIVE
The aim of this pilot study is to explore perception and acceptability of mobile health (mhealth) and e-voucher and to determine the feasibility of conducting a large cluster randomized trial to determine the effects of combining e-vouchers and a mobile application compared with usual care in improving access to and use of maternal health services.
METHODS METHODS
This is a multimethod study that comprises two phases. The first phase is the development of the mobile phone app, which includes a qualitative formative study through in-depth key informant interviews and focus group discussions. The second phase is a cluster randomized control trial assessing the combination of e-vouchers and a mobile application compared with usual care in improving access to and use of maternal health services. Feasibility will be determined based on evaluating randomization, contamination, enrollment rate, complete follow up, compliance rate, success in matching data from different sources, and data completeness.
ETHICS AND DISCUSSION UNASSIGNED
Ethics approval has been granted, and the trial has been registered in the Pan-African Clinical Trials Registry. We will disseminate our findings through peer-reviewed manuscripts and conference presentations. Findings from this study will inform the design and conduct of a larger randomized trial.
TRIAL REGISTRATION BACKGROUND
PACTR201808703097367. The trial on the Pan African Clinical Trials Registry.

Identifiants

pubmed: 32313683
doi: 10.1186/s40814-020-00589-y
pii: 589
pmc: PMC7155248
doi:

Types de publication

Journal Article

Langues

eng

Pagination

45

Informations de copyright

© The Author(s) 2020.

Déclaration de conflit d'intérêts

Competing interestThe authors declare that they have no competing interest.

Références

Obstet Gynecol Int. 2016;2016:5423413
pubmed: 27703482
BMC Pregnancy Childbirth. 2014 Jan 17;14:30
pubmed: 24438560
J Health Soc Behav. 1995 Mar;36(1):1-10
pubmed: 7738325
Stat Med. 1990 Jan-Feb;9(1-2):65-71; discussion 71-2
pubmed: 2345839
Trop Med Int Health. 2011 Jan;16(1):84-96
pubmed: 21044235
BMJ Open. 2013 Jun 25;3(6):
pubmed: 23801710
Reprod Health. 2011 May 03;8:10
pubmed: 21539744
Pan Afr Med J. 2015 Aug 31;21:321
pubmed: 26587168
Syst Rev. 2017 Jun 6;6(1):110
pubmed: 28587676
Health Educ Q. 1988 Fall;15(3):299-315
pubmed: 3056876
Adm Policy Ment Health. 2011 Jan;38(1):44-53
pubmed: 20967495
Trials. 2014 Jul 03;15:264
pubmed: 24993581
Int J Equity Health. 2011 Nov 30;10:57
pubmed: 22129437
Health Policy Plan. 2015 Feb;30(1):88-99
pubmed: 24371219
BMJ. 2010 Mar 23;340:c332
pubmed: 20332509
Stat Med. 2001 Feb 15;20(3):401-16
pubmed: 11180310
J Glob Health. 2016 Jun;6(1):010401
pubmed: 26649177
Matern Child Health J. 2011 Nov;15(8):1427-34
pubmed: 21057862
PLoS One. 2013;8(1):e53747
pubmed: 23335973
BMC Med Res Methodol. 2010 Jan 06;10:1
pubmed: 20053272
Lancet. 2010 Oct 9;376(9748):1261-71
pubmed: 20933263
Soc Sci Med. 1994 Apr;38(8):1091-110
pubmed: 8042057
BMC Pregnancy Childbirth. 2015 Apr 17;15:95
pubmed: 25885481
BMC Pregnancy Childbirth. 2013 Jan 22;13:18
pubmed: 23339515
Health Policy Plan. 2013 Mar;28(2):134-42
pubmed: 22437506
BMC Pregnancy Childbirth. 2010 Jan 07;10:1
pubmed: 20059767
Soc Sci Med. 2012 Apr;74(7):989-96
pubmed: 22326107
Am J Health Promot. 1997 Sep-Oct;12(1):38-48
pubmed: 10170434
J Health Popul Nutr. 2013 Dec;31(4 Suppl 2):106-28
pubmed: 24992806
Epidemiol Perspect Innov. 2004 Dec 17;1(1):6
pubmed: 15606913
Ann Intern Med. 2013 Feb 5;158(3):200-7
pubmed: 23295957
BMJ. 2016 Mar 17;352:i1174
pubmed: 26988021
BMJ Open. 2016 Jan 12;6(1):e009044
pubmed: 26758257
Cochrane Database Syst Rev. 2012 Jul 11;(7):CD007458
pubmed: 22786507
Fam Pract. 2000 Apr;17(2):192-6
pubmed: 10758085

Auteurs

Miriam N Nkangu (MN)

1School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.
Health Promotion Alliance Cameroon (HPAC), Yaounde, Cameroon.
9WHO Collaborating Center for Knowledge Translation and Health Technology Assessment in Health Equity, Ottawa University, Ottawa, Canada.
10Bruyere Research Institute, Ottawa, Canada.

Patrick M Okwen (PM)

Effective Basic Services (eBASE) Africa, Bamenda, Cameroon.

Lawrence Mbuagbaw (L)

3Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada.
4Biostatistics Unit, The Research Institute, St Joseph's Healthcare Hamilton, Hamilton, Canada.
Centre for the Development of Best Practices in Health, Yaounde, Cameroon.

Donald K Weledji (DK)

SPRL Donwels System, Brussels, Belgium.

Janet Hatcher Roberts (JH)

1School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.
9WHO Collaborating Center for Knowledge Translation and Health Technology Assessment in Health Equity, Ottawa University, Ottawa, Canada.
10Bruyere Research Institute, Ottawa, Canada.

Sanni Yaya (S)

8School of International Development and Global Studies, University of Ottawa, Ottawa, Canada.

Classifications MeSH