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Proactive community case management and child survival: protocol for a cluster randomised controlled trial.

Abstract：

INTRODUCTION:Community health workers (CHWs)-shown to improve access to care and reduce maternal, newborn, and child morbidity and mortality-are re-emerging as a key strategy to achieve health-related Sustainable Development Goals (SDGs). However, recent evaluations of national programmes for CHW-led integrated community case management (iCCM) of common childhood illnesses have not found benefits on access to care and child mortality. Developing innovative ways to maximise the potential benefits of iCCM is critical to achieving the SDGs. METHODS AND ANALYSIS:An unblinded, cluster randomised controlled trial in rural Mali aims to test the efficacy of the addition of door-to-door proactive case detection by CHWs compared with a conventional approach to iCCM service delivery in reducing under-five mortality. In the intervention arm, 69 village clusters will have CHWs who conduct daily proactive case-finding home visits and deliver doorstep counsel, care, referral and follow-up. In the control arm, 68 village clusters will have CHWs who provide the same services exclusively out of a fixed community health site. A baseline population census will be conducted of all people living in the study area. All women of reproductive age will be enrolled in the study and surveyed at baseline, 12, 24 and 36 months. The survey includes a life table tracking all live births and deaths occurring prior to enrolment through the 36 months of follow-up in order to measure the primary endpoint: under-five mortality, measured as deaths among children under 5 years of age per 1000 person-years at risk of mortality. ETHICS AND DISSEMINATION:The trial has received ethical approval from the Ethics Committee of the Faculty of Medicine, Pharmacy and Dentistry, University of Bamako. The results will be disseminated through peer-reviewed publications, national and international conferences and workshops, and media outlets. TRIAL REGISTRATION NUMBER:NCT02694055; Pre-results.

journal_name

BMJ Open

journal_title

BMJ open

authors

Whidden C,Treleaven E,Liu J,Padian N,Poudiougou B,Bautista-Arredondo S,Fay MP,Samaké S,Cissé AB,Diakité D,Keita Y,Johnson AD,Kayentao K

doi

10.1136/bmjopen-2018-027487

subject

Has Abstract

pub_date

2019-08-26 00:00:00

pages

e027487

issue

8

issn

2044-6055

pii

bmjopen-2018-027487

journal_volume

9

pub_type

杂志文章,多中心研究,随机对照试验

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