Effectiveness of an HIV-adapted IMCI Training and Supervision Programme for Community Health Workers
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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.
Condition | Intervention |
---|---|
Prevention of Mother-to-child Transmission of HIV Antenatal Health Care Utilization Postnatal Health Care Utilization Infant Feeding Practices |
Behavioral: Enhanced HIV and MCH training for CHW |
Study Type: | Interventional |
Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Outcomes Assessor) Primary Purpose: Health Services Research |
Official Title: | The Effectiveness of an HIV-adapted IMCI Training and Supervision Programme of Community Caregivers to Support Interventions That Will Reduce MTCT and Improve Delivery of Other Essential Newborn and Child Survival Interventions |
- Prevalence of antenatal booking before 20 weeks gestation [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- Prevalence of presentation for post-natal care within 7 days of delivery [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- Prevalence of exclusive breast-feeding practice at 14 weeks [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- Coverage of HIV PCR testing at 6 weeks [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- Proportion of women who attended for antenatal care at least 4 times in pregnancy [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- Proportion of deliveries by skilled birth attendant at a health facility [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- Proportion of age-eligible infants who received recommended immunizations at 6, 10, and 14 weeks and 9 and 12 months [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- Proportion of children whose growth was monitored by CCG at home [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- Prevalence of exclusive breast-feeding practice at 6 months [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- Proportion of women without known HIV-positive status who received HIV test in pregnancy [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- Proportion of women without known HIV-positive status who received HIV test result in pregnancy [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- Proportion of HIV-positive women who received CD4 test results [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- Proportion of HIV-positive women who received ARV prophylaxis in pregnancy and during delivery [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- Proportion of infants born to HIV-positive mothers who received ARV prophylaxis following birth (including during breastfeeding where appropriate) [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- 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 ] [ Designated as safety issue: No ]
- 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 ] [ Designated as safety issue: No ]
Estimated Enrollment: | 3840 |
Study Start Date: | April 2012 |
Estimated Study Completion Date: | March 2014 |
Estimated Primary Completion Date: | January 2014 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
---|---|
Experimental: Enhanced HIV and MCH training for CHW
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.
|
Behavioral: Enhanced HIV and MCH training for CHW |
No Intervention: Standard of Care |
![](https://webarchive.library.unt.edu/web/20130317075817im_/http://clinicaltrials.gov/ct2/html/images/frame/triangle.gif)
Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
Community caregivers
- CCGs who work in Ugu District
- age 18 years or older
- with grade 9 education or greater
Mothers
- Mothers age 18 years and older who delivered a live-born infant within the prior 12 months
- Reside in households served by participating CCGs.
Exclusion Criteria:
- None
![](https://webarchive.library.unt.edu/web/20130317075817im_/http://clinicaltrials.gov/ct2/html/images/frame/triangle.gif)
Contact: Jennifer Reddy, MBChD | Reddyj@ukzn.ac.za |
South Africa | |
20000+ Partnership, UKZN | Recruiting |
Durban, KwaZulu-Natal, South Africa | |
Contact: Jennifer Reddy, MBChD Reddyj@ukzn.ac.za | |
Principal Investigator: Jennifer Reddy, MBChB |
Principal Investigator: | Jennifer Reddy, MBChB | 20,000+ Partnership, University of KwaZulu-Natal |
![](https://webarchive.library.unt.edu/web/20130317075817im_/http://clinicaltrials.gov/ct2/html/images/frame/triangle.gif)
No publications provided
Responsible Party: | Dr. Jennifer Reddy, Director, University of KwaZulu |
ClinicalTrials.gov Identifier: | NCT01774136 History of Changes |
Other Study ID Numbers: | Nompilo |
Study First Received: | January 20, 2013 |
Last Updated: | January 20, 2013 |
Health Authority: | United States: Federal Government |
Keywords provided by University of KwaZulu:
community health workers HIV PMTCT antenatal |
postnatal breastfeeding South Africa |
ClinicalTrials.gov processed this record on March 14, 2013