This is a cluster randomized controlled trial (C-RCT) to evaluate the effectiveness of a Community-Integrated Management of Childhood Illness (C-IMCI) training for community caregivers (CCGs), adapted to include HIV-related interventions, on the delivery of maternal, newborn and child health interventions within households in rural communities in Ugu District, KwaZulu-Natal (KZN) Province, South Africa. The intervention includes two components: (1) a 2-week HIV/C-IMCI training for CCGs and their associated facilitators and supervisors, and (2) continuous support and supervision following the continuous quality improvement (CQI) framework, a low-technology approach to management and supervision of health programs. The primary objectives of the proposed evaluation are to measure the effect of the intervention on key outcomes, including early uptake of antenatal care, facility based delivery, postnatal visits, coverage of exclusive breastfeeding, and uptake of HIV PCR testing in infants at 6 weeks. We will also examine the effects of the intervention on immunization uptake up to 12 months and knowledge and practices of CCGs and mothers pertaining to maternal, newborn and child health.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE
Enrollment
1,342
20000+ Partnership, UKZN
Durban, KwaZulu-Natal, South Africa
Prevalence of antenatal booking before 20 weeks gestation
Time frame: 1 year
Prevalence of presentation for post-natal care within 7 days of delivery
Time frame: 1 year
Prevalence of exclusive breast-feeding practice at 14 weeks
Time frame: 1 year
Coverage of HIV PCR testing at 6 weeks
Time frame: 1 year
Proportion of women who attended for antenatal care at least 4 times in pregnancy
Time frame: 1 year
Proportion of deliveries by skilled birth attendant at a health facility
Time frame: 1 year
Proportion of age-eligible infants who received recommended immunizations at 6, 10, and 14 weeks and 9 and 12 months
Time frame: 1 year
Proportion of children whose growth was monitored by CCG at home
Time frame: 1 year
Prevalence of exclusive breast-feeding practice at 6 months
Time frame: 1 year
Proportion of women without known HIV-positive status who received HIV test in pregnancy
Time frame: 1 year
Proportion of women without known HIV-positive status who received HIV test result in pregnancy
Time frame: 1 year
Proportion of HIV-positive women who received CD4 test results
Time frame: 1 year
Proportion of HIV-positive women who received ARV prophylaxis in pregnancy and during delivery
Time frame: 1 year
Proportion of infants born to HIV-positive mothers who received ARV prophylaxis following birth (including during breastfeeding where appropriate)
Time frame: 1 year
Knowledge and practices of mothers in the community regarding: infant feeding, HIV, availability of interventions to reduce HIV transmission, newborn care practices and recognition of serious illness in children and management of childhood illnesses
Time frame: 1 year
Knowledge and practices of CCGs with regards to: HIV-specific interventions to improve maternal health, reduce HIV transmission and improve child survival
Time frame: 1 year
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.