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首页> 外文期刊>Trials >Community mobilisation with women's groups facilitated by Accredited Social Health Activists (ASHAs) to improve maternal and newborn health in underserved areas of Jharkhand and Orissa: study protocol for a cluster-randomised controlled trial
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Community mobilisation with women's groups facilitated by Accredited Social Health Activists (ASHAs) to improve maternal and newborn health in underserved areas of Jharkhand and Orissa: study protocol for a cluster-randomised controlled trial

机译：由经认可的社会卫生活动家（ASHA）推动的与妇女团体的社区动员，以改善贾坎德邦和奥里萨邦服务不足地区的孕产妇和新生儿健康：一项整群随机对照试验的研究方案

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Background Around a quarter of the world's neonatal and maternal deaths occur in India. Morbidity and mortality are highest in rural areas and among the poorest wealth quintiles. Few interventions to improve maternal and newborn health outcomes with government-mandated community health workers have been rigorously evaluated at scale in this setting. The study aims to assess the impact of a community mobilisation intervention with women's groups facilitated by ASHAs to improve maternal and newborn health outcomes among rural tribal communities of Jharkhand and Orissa. Methods/design The study is a cluster-randomised controlled trial and will be implemented in five districts, three in Jharkhand and two in Orissa. The unit of randomisation is a rural cluster of approximately 5000 population. We identified villages within rural, tribal areas of five districts, approached them for participation in the study and enrolled them into 30 clusters, with approximately 10 ASHAs per cluster. Within each district, 6 clusters were randomly allocated to receive the community intervention or to the control group, resulting in 15 intervention and 15 control clusters. Randomisation was carried out in the presence of local stakeholders who selected the cluster numbers and allocated them to intervention or control using a pre-generated random number sequence. The intervention is a participatory learning and action cycle where ASHAs support community women's groups through a four-phase process in which they identify and prioritise local maternal and newborn health problems, implement strategies to address these and evaluate the result. The cycle is designed to fit with the ASHAs' mandate to mobilise communities for health and to complement their other tasks, including increasing institutional delivery rates and providing home visits to mothers and newborns. The trial's primary endpoint is neonatal mortality during 24 months of intervention. Additional endpoints include home care practices and health care-seeking in the antenatal, delivery and postnatal period. The impact of the intervention will be measured through a prospective surveillance system implemented by the project team, through which mothers will be interviewed around six weeks after delivery. Cost data and qualitative data are collected for cost-effectiveness and process evaluations. Study registration ISRCTN: ISRCTN31567106
机译：背景技术印度约有四分之一的新生儿和产妇死亡。在农村地区和最贫穷的五分之一人口中，发病率和死亡率最高。在这种情况下，很少对政府授权的社区卫生工作者采取的改善孕产妇和新生儿健康结果的干预措施进行过严格评估。这项研究的目的是评估社区动员干预与ASHA促进的妇女团体改善贾坎德邦和奥里萨邦农村部落社区的孕产妇和新生儿健康结果的影响。方法/设计这项研究是一项整群随机对照试验，将在五个地区实施，三个地区在贾坎德邦，两个地区在奥里萨邦。随机单位是大约5000人口的农村地区。我们确定了五个地区的农村，部落地区内的村庄，让他们参与研究，并将其分为30个集群，每个集群大约10个ASHA。在每个区中，随机分配了6个集群以接受社区干预或接受对照组干预，从而产生15个干预和15个控制集群。随机化是在当地利益相关者在场的情况下进行的，他们选择了群集编号，并使用预先生成的随机编号序列将其分配给干预或控制。干预是一个参与式学习和行动周期，在这个过程中，ASHA通过四个阶段的过程来支持社区妇女团体，在过程中，她们确定并优先考虑当地的孕产妇和新生儿健康问题，实施解决这些问题的策略并评估结果。该周期旨在符合ASHA的使命，动员社区促进健康并补充其其他任务，包括提高机构分娩率并向母亲和新生儿提供家访。该试验的主要终点是干预后24个月的新生儿死亡率。其他目标包括产前，分娩和产后期间的家庭护理实践和寻求健康护理。干预措施的影响将通过项目团队实施的前瞻性监视系统进行评估，通过该系统，在分娩后大约六周内将对母亲进行访谈。收集成本数据和定性数据以进行成本效益和过程评估。研究注册ISRCTN：ISRCTN31567106

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