Accelerating Newborn Survival in Ghana Through a Low-dose, High-frequency Health Worker Training Approach

Jhpiego40 enrolled

Overview

This study assesses the effect of a low-dose, high-frequency training approach on long-term evidence-based skill retention among skilled birth attendants and impact on adverse birth outcomes at hospitals in Ghana.

In-service training for skilled birth attendants (SBAs) is one of the most common interventions to address lack of knowledge and skills. However, these training interventions are seldom evaluated for effectiveness in improving learning or performance. This study study is a cluster-randomized waitlist trial implemented in 40 public and mission hospitals in Ghana. It assesses the effect of a low-dose, high-frequency (LDHF) training approach to update hospital-based SBAs in key evidence-based intrapartum and immediate newborn care practices, using current global guidelines.The LDHF approach includes two 4-day onsite sessions (low dose) with weekly practice sessions, SMS quizzes and reminders, and mentoring via mobile phone and onsite visits between trainings (high frequency). The low-dose sessions include competency acquisition through simulation, case-based learning, and small content packages spread over short time intervals. Eligible hospitals will be stratified by geographic region and caseload, and then randomly assigned to one of four implementation waves. The pipeline randomization allows for rigorous evaluation while the program is rolled out to all facilities.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Enrollment

Conditions

Stillbirth Neonatal Death

Interventions

Low dose high frequency health worker training approachBEHAVIORAL

* Two 4-day training sessions for skilled birth attendants * 1-day peer practice coordinator training after first training session * Weekly, peer-led practice sessions using MamaNatalie® and NeoNatalie™ anatomic models * SMS reminder messages and quizzes * Routine telephone calls between master mentors and peer practice coordinators, and between project staff and master mentors * Health information officer training * Data collection and use training * Supply of simulators, newborn resuscitation equipment, and delivery sets

Active ComparisonBEHAVIORAL

Training on data collection and reporting

Eligibility

Sex: ALL

Medical Language ↔ Plain English

INCLUSION CRITERIA - FACILITIES: * Public or faith based hospital * At least three skilled birth attendants on staff * At least 30 births per month EXCLUSION CRITERIA - FACILITIES: * Private hospital * Public or faith based hospital with less than three skilled birth attendants on staff * Public or faith based hospital with less than 30 births per month INCLUSION CRITERIA - SERVICE PROVIDERS: \* Health providers who attend births in participating health facilities and consent to be assessed at the time of enrollment and at several points in time over the study period EXCLUSION CRITERIA - SERVICE PROVIDERS: \* Health providers who decline to participate

Outcomes

Primary Outcomes

institutional twenty-four hour newborn mortality rate

death within 24 hours, or before discharge, of a newborn who breathed at birth

Time frame: 1 day

institutional intrapartum stillbirth rate

proportion of all facility births that resulted in intrapartum stillbirth

Time frame: 1 day

Secondary Outcomes

skilled birth attendant knowledge and skills

score on written and practical examinations on routine and emergency obstetric and newborn care

Time frame: Pre-test (before training) - post-test (immediately after training) - endline (12 months)

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.