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| Name | Class |
|---|---|
| Bill and Melinda Gates Foundation | OTHER |
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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention | Experimental | Low-dose high-frequency health worker training approach to update skilled birth attendants in key evidence-based intrapartum and immediate newborn care practices |
|
| Comparison | Active Comparator | Training on data collection and reporting |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Low dose high frequency health worker training approach | Behavioral |
|
| Measure | Description | Time Frame |
|---|---|---|
| institutional twenty-four hour newborn mortality rate | death within 24 hours, or before discharge, of a newborn who breathed at birth | 1 day |
| institutional intrapartum stillbirth rate | proportion of all facility births that resulted in intrapartum stillbirth | 1 day |
| Measure | Description | Time Frame |
|---|---|---|
| skilled birth attendant knowledge and skills | score on written and practical examinations on routine and emergency obstetric and newborn care | Pre-test (before training) - post-test (immediately after training) - endline (12 months) |
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INCLUSION CRITERIA - FACILITIES:
EXCLUSION CRITERIA - FACILITIES:
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
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| Name | Affiliation | Role |
|---|---|---|
| Patricia Gomez | Senior Technical Advisor | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29566659 | Derived | Gomez PP, Nelson AR, Asiedu A, Addo E, Agbodza D, Allen C, Appiagyei M, Bannerman C, Darko P, Duodu J, Effah F, Tappis H. Accelerating newborn survival in Ghana through a low-dose, high-frequency health worker training approach: a cluster randomized trial. BMC Pregnancy Childbirth. 2018 Mar 22;18(1):72. doi: 10.1186/s12884-018-1705-5. |
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| ID | Term |
|---|---|
| D050497 | Stillbirth |
| D066087 | Perinatal Death |
| ID | Term |
|---|---|
| D005313 | Fetal Death |
| D011248 | Pregnancy Complications |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
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|
| Active Comparison | Behavioral | Training on data collection and reporting |
|
| D003643 | Death |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |