Trial Outcomes & Findings for Randomized Controlled Trial to Address Unintended Pregnancy Rates in Low Resource Settings (NCT NCT05328648)
NCT ID: NCT05328648
Last Updated: 2025-05-23
Results Overview
The measure of current modern contraceptive use is a binary variable (0=non-use; 1=use), attained by first asking participants, "Are you (or your partner) currently doing something or using any method to delay or avoid getting pregnant?" Those with an affirmative response are then asked, "What method are you using?" Modern contraceptive methods will be defined to include female or male sterilization, intrauterine device, implant, injectable contraception, oral contraceptive pill, male or female condom, and any other modern methods. The percent of women using modern contraceptives at baseline was subtracted from the percent using modern contraceptives at endline, and that difference is reported.
COMPLETED
NA
5726 participants
Baseline, 12 months
2025-05-23
Participant Flow
Two types of participants were enrolled at two time points. 2484 and 2501 women were enrolled in the individual-level survey at baseline and endline, respectively. 345 and 396 healthcare providers (staff) were enrolled in the facility-level survey at baseline and endline, respectively. The facility-level surveys were conducted across 137 public-sector facilities (i.e., the unit of randomization). 2484+345+2501+396 = 5,726. No facility facilitators were enrolled.
All public health facilities in the study area were included and randomly assigned to 1 of 3 intervention arms. Data was collected through 2 cross-sectional surveys, at baseline and 12 months following intervention implementation. A random sample of reproductive age women and up to 10 providers at each facility, were surveyed at both time points. The sum of participants represents the total number of interviews not the individual respondents, as participants could be sampled at both time points.
Unit of analysis: Facilities
Participant milestones
| Measure |
Community Score Card
In the Community Score Card approach, community members come together to document challenges they encounter when seeking services and develop a corresponding set of indicators that can be used to produce a validated facility score. The score is shared with the community and a collaborative process between key community members and facility staff takes place to develop feasible solutions and a strategic action plan.
Community Score Card: In Community Score Card intervention, all communities associated with the targeted facilities will assess the primary barriers to quality family planning service delivery and develop indicators. The communities will then each complete the score card and generate ideas for quality improvement. Family planning providers in the target facilities will meet and determine the barriers to high quality family planning service delivery. Providers will decide on priority areas and make suggestions for improving service delivery. Study facilitators will bring these two groups together to share their respective score cards and jointly develop an action. Within the action plan, agreed upon responsibilities will be assigned and a timeline will be communicated.
|
Citizen Report Card
In the Citizen Report Card approach, individual-level feedback is collected from actual clients of target facilities, via a structured questionnaire, to assess facility performance and generate a public record of service quality. In addition to sharing the final report card with communities, engaged policymakers are invited to use the citizen feedback to improve service delivery.
Citizen Report Card: Citizen Report Card (CRC): The data from the CRC questionnaire will be analyzed and translated into a report card. Extensive dissemination activities will ensure the CRC is widely shared with members of the community. The goal is to create a public record of service quality.
|
Control
Communities in the control arm will not receive an intervention.
|
|---|---|---|---|
|
Baseline Women
STARTED
|
828 45
|
835 46
|
821 46
|
|
Baseline Women
COMPLETED
|
828 45
|
835 46
|
821 46
|
|
Baseline Women
NOT COMPLETED
|
0 0
|
0 0
|
0 0
|
|
Baseline Providers
STARTED
|
106 45
|
133 46
|
106 46
|
|
Baseline Providers
Providers Interviewed
|
106 45
|
133 46
|
106 46
|
|
Baseline Providers
Providers Not Interviewed
|
23 17
|
18 13
|
28 15
|
|
Baseline Providers
COMPLETED
|
106 45
|
133 46
|
106 46
|
|
Baseline Providers
NOT COMPLETED
|
0 0
|
0 0
|
0 0
|
|
Endline Women
STARTED
|
822 45
|
850 46
|
829 46
|
|
Endline Women
COMPLETED
|
822 45
|
850 46
|
829 46
|
|
Endline Women
NOT COMPLETED
|
0 0
|
0 0
|
0 0
|
|
Endline Providers
STARTED
|
148 45
|
125 46
|
123 46
|
|
Endline Providers
Providers Interviewed
|
148 45
|
125 46
|
123 46
|
|
Endline Providers
Providers Not Interviewed
|
6 5
|
6 6
|
6 5
|
|
Endline Providers
COMPLETED
|
148 45
|
125 46
|
123 46
|
|
Endline Providers
NOT COMPLETED
|
0 0
|
0 0
|
0 0
|
Reasons for withdrawal
Withdrawal data not reported
Baseline Characteristics
Baseline characteristics are summarized by the number of participants completing each survey period.
Baseline characteristics by cohort
| Measure |
Community Score Card
n=1904 Participants
In the Community Score Card approach, community members come together to document challenges they encounter when seeking services and develop a corresponding set of indicators that can be used to produce a validated facility score. The score is shared with the community and a collaborative process between key community members and facility staff takes place to develop feasible solutions and a strategic action plan.
|
Citizen Report Card
n=1943 Participants
In the Citizen Report Card approach, individual-level feedback is collected from actual clients of target facilities, via a structured questionnaire, to assess facility performance and generate a public record of service quality. In addition to sharing the final report card with communities, engaged policymakers are invited to use the citizen feedback to improve service delivery.
|
Control
n=1879 Participants
Communities in the control arm will not receive an intervention.
|
Total
n=5726 Participants
Total of all reporting groups
|
|---|---|---|---|---|
|
Age, Continuous
Baseline Women
|
30.43 years
STANDARD_DEVIATION 8.44 • n=828 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
30.99 years
STANDARD_DEVIATION 8.57 • n=835 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
30.22 years
STANDARD_DEVIATION 8.72 • n=821 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
30.55 years
STANDARD_DEVIATION 8.58 • n=2484 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
|
Age, Continuous
Baseline Providers
|
36.25 years
STANDARD_DEVIATION 7.82 • n=106 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
37.52 years
STANDARD_DEVIATION 8.83 • n=133 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
37.96 years
STANDARD_DEVIATION 8.54 • n=106 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
37.26 years
STANDARD_DEVIATION 8.45 • n=345 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
|
Age, Continuous
Endline Women
|
30.66 years
STANDARD_DEVIATION 8.36 • n=822 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
31.31 years
STANDARD_DEVIATION 8.49 • n=850 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
31.11 years
STANDARD_DEVIATION 8.52 • n=829 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
31.03 years
STANDARD_DEVIATION 8.46 • n=2501 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
|
Age, Continuous
Endline Providers
|
38.05 years
STANDARD_DEVIATION 7.73 • n=148 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
39.52 years
STANDARD_DEVIATION 8.22 • n=125 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
38.93 years
STANDARD_DEVIATION 8.55 • n=123 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
38.79 years
STANDARD_DEVIATION 8.15 • n=396 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
|
Sex: Female, Male
Baseline Women · Female
|
828 Participants
n=828 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
835 Participants
n=835 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
821 Participants
n=821 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
2484 Participants
n=2484 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
|
Sex: Female, Male
Baseline Women · Male
|
0 Participants
n=828 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
0 Participants
n=835 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
0 Participants
n=821 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
0 Participants
n=2484 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
|
Sex: Female, Male
Baseline Providers · Female
|
69 Participants
n=106 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
100 Participants
n=133 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
84 Participants
n=106 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
253 Participants
n=345 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
|
Sex: Female, Male
Baseline Providers · Male
|
37 Participants
n=106 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
33 Participants
n=133 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
22 Participants
n=106 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
92 Participants
n=345 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
|
Sex: Female, Male
Endline Women · Female
|
822 Participants
n=822 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
850 Participants
n=850 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
829 Participants
n=829 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
2501 Participants
n=2501 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
|
Sex: Female, Male
Endline Women · Male
|
0 Participants
n=822 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
0 Participants
n=850 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
0 Participants
n=829 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
0 Participants
n=2501 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
|
Sex: Female, Male
Endline Providers · Female
|
100 Participants
n=148 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
90 Participants
n=125 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
99 Participants
n=123 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
289 Participants
n=396 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
|
Sex: Female, Male
Endline Providers · Male
|
48 Participants
n=148 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
35 Participants
n=125 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
24 Participants
n=123 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
107 Participants
n=396 Participants • Baseline characteristics are summarized by the number of participants completing each survey period.
|
|
Race and Ethnicity Not Collected
|
—
|
—
|
—
|
0 Participants
Race and Ethnicity were not collected from any participant.
|
|
Region of Enrollment
Kenya
|
1904 Participants
n=1904 Participants
|
1943 Participants
n=1943 Participants
|
1879 Participants
n=1879 Participants
|
5726 Participants
n=5726 Participants
|
PRIMARY outcome
Timeframe: Baseline, 12 monthsThe measure of current modern contraceptive use is a binary variable (0=non-use; 1=use), attained by first asking participants, "Are you (or your partner) currently doing something or using any method to delay or avoid getting pregnant?" Those with an affirmative response are then asked, "What method are you using?" Modern contraceptive methods will be defined to include female or male sterilization, intrauterine device, implant, injectable contraception, oral contraceptive pill, male or female condom, and any other modern methods. The percent of women using modern contraceptives at baseline was subtracted from the percent using modern contraceptives at endline, and that difference is reported.
Outcome measures
| Measure |
Community Score Card
n=1650 Participants
In the Community Score Card approach, community members come together to document challenges they encounter when seeking services and develop a corresponding set of indicators that can be used to produce a validated facility score. The score is shared with the community and a collaborative process between key community members and facility staff takes place to develop feasible solutions and a strategic action plan.
|
Citizen Report Card
n=1685 Participants
In the Citizen Report Card approach, individual-level feedback is collected from actual clients of target facilities, via a structured questionnaire, to assess facility performance and generate a public record of service quality. In addition to sharing the final report card with communities, engaged policymakers are invited to use the citizen feedback to improve service delivery.
|
Control
n=1650 Participants
Communities in the control arm will not receive an intervention.
|
|---|---|---|---|
|
Percentage Change in Current Modern Contraceptive Use
|
-1.1 percentage of participants
|
1.4 percentage of participants
|
1.5 percentage of participants
|
PRIMARY outcome
Timeframe: Baseline, at the end of 12-month intervention (Endline)The measure of women's knowledge of patient rights is a 7 item scale with answers on a 5 point Likert scale. Possible scores range from 7 to 35. Higher scores reflect greater knowledge of patient rights. The measure of women's knowledge of patient rights is implemented in the women's individual-level questionnaire in the pre- and post-intervention surveys. The percent change in the mean score across all women is presented, using the formula (endline-baseline)/baseline.
Outcome measures
| Measure |
Community Score Card
n=1650 Participants
In the Community Score Card approach, community members come together to document challenges they encounter when seeking services and develop a corresponding set of indicators that can be used to produce a validated facility score. The score is shared with the community and a collaborative process between key community members and facility staff takes place to develop feasible solutions and a strategic action plan.
|
Citizen Report Card
n=1685 Participants
In the Citizen Report Card approach, individual-level feedback is collected from actual clients of target facilities, via a structured questionnaire, to assess facility performance and generate a public record of service quality. In addition to sharing the final report card with communities, engaged policymakers are invited to use the citizen feedback to improve service delivery.
|
Control
n=1650 Participants
Communities in the control arm will not receive an intervention.
|
|---|---|---|---|
|
Mean Knowledge of Patient Rights Score
Baseline
|
18.1 score on a scale
Standard Deviation 3.7
|
18.0 score on a scale
Standard Deviation 3.6
|
18.0 score on a scale
Standard Deviation 3.6
|
|
Mean Knowledge of Patient Rights Score
Endline
|
18.0 score on a scale
Standard Deviation 3.8
|
17.5 score on a scale
Standard Deviation 3.6
|
17.8 score on a scale
Standard Deviation 3.6
|
PRIMARY outcome
Timeframe: Baseline, at the end of 12-month intervention (Endline)The measure of women's agency within their community is an 8 item scale. Answers are on a 5 point scale with options "Completely sure" "Sure" "Neither sure or unsure" "Not sure" or "Not sure at all." Possible scores range from 8 to 40. Higher scores reflect greater agency for women within their community. The measure of women's agency within their community is implemented in the women's individual-level questionnaire in the pre- and post-intervention surveys.
Outcome measures
| Measure |
Community Score Card
n=1650 Participants
In the Community Score Card approach, community members come together to document challenges they encounter when seeking services and develop a corresponding set of indicators that can be used to produce a validated facility score. The score is shared with the community and a collaborative process between key community members and facility staff takes place to develop feasible solutions and a strategic action plan.
|
Citizen Report Card
n=1685 Participants
In the Citizen Report Card approach, individual-level feedback is collected from actual clients of target facilities, via a structured questionnaire, to assess facility performance and generate a public record of service quality. In addition to sharing the final report card with communities, engaged policymakers are invited to use the citizen feedback to improve service delivery.
|
Control
n=1650 Participants
Communities in the control arm will not receive an intervention.
|
|---|---|---|---|
|
Mean Women's Agency Within Their Community Score
Baseline
|
20.8 score on a scale
Standard Deviation 6.5
|
21.1 score on a scale
Standard Deviation 6.4
|
21.2 score on a scale
Standard Deviation 6.1
|
|
Mean Women's Agency Within Their Community Score
Endline
|
21.5 score on a scale
Standard Deviation 6.7
|
21.2 score on a scale
Standard Deviation 7.2
|
21.7 score on a scale
Standard Deviation 7.1
|
PRIMARY outcome
Timeframe: Baseline, at the end of 12-month intervention (Endline)The measure of women's agency within a healthcare facility is a 2 item scale. Answers are on a 5 point scale with options "Completely sure" "Sure" "Neither sure or unsure" "Not sure" or "Not sure at all." Possible scores range from 2 to 10. Higher scores reflect greater agency for women within a healthcare facility. The measure of women's agency within a healthcare facility is implemented in the women's individual-level questionnaire in the pre- and post-intervention surveys.
Outcome measures
| Measure |
Community Score Card
n=1650 Participants
In the Community Score Card approach, community members come together to document challenges they encounter when seeking services and develop a corresponding set of indicators that can be used to produce a validated facility score. The score is shared with the community and a collaborative process between key community members and facility staff takes place to develop feasible solutions and a strategic action plan.
|
Citizen Report Card
n=1685 Participants
In the Citizen Report Card approach, individual-level feedback is collected from actual clients of target facilities, via a structured questionnaire, to assess facility performance and generate a public record of service quality. In addition to sharing the final report card with communities, engaged policymakers are invited to use the citizen feedback to improve service delivery.
|
Control
n=1650 Participants
Communities in the control arm will not receive an intervention.
|
|---|---|---|---|
|
Mean Women's Agency Within a Healthcare Facility
Baseline
|
5.8 score on a scale
Standard Deviation 2.1
|
6.0 score on a scale
Standard Deviation 2.0
|
5.9 score on a scale
Standard Deviation 2.2
|
|
Mean Women's Agency Within a Healthcare Facility
Endline
|
5.6 score on a scale
Standard Deviation 2.1
|
5.7 score on a scale
Standard Deviation 2.2
|
5.8 score on a scale
Standard Deviation 2.0
|
PRIMARY outcome
Timeframe: Baseline, at the end of 12-month intervention (Endline)The measure of women's facility satisfaction is an 11 item scale with answers on a 5 point Likert scale. Possible scores range from 11 to 55. Higher scores reflect greater facility satisfaction. The measure of women's facility satisfaction is implemented in the women's individual-level questionnaire in the pre- and post-intervention surveys.
Outcome measures
| Measure |
Community Score Card
n=1650 Participants
In the Community Score Card approach, community members come together to document challenges they encounter when seeking services and develop a corresponding set of indicators that can be used to produce a validated facility score. The score is shared with the community and a collaborative process between key community members and facility staff takes place to develop feasible solutions and a strategic action plan.
|
Citizen Report Card
n=1685 Participants
In the Citizen Report Card approach, individual-level feedback is collected from actual clients of target facilities, via a structured questionnaire, to assess facility performance and generate a public record of service quality. In addition to sharing the final report card with communities, engaged policymakers are invited to use the citizen feedback to improve service delivery.
|
Control
n=1650 Participants
Communities in the control arm will not receive an intervention.
|
|---|---|---|---|
|
Mean Women's Facility Satisfaction Score
Baseline
|
23.6 score on a scale
Standard Deviation 4.2
|
23.1 score on a scale
Standard Deviation 4.0
|
23.2 score on a scale
Standard Deviation 4.1
|
|
Mean Women's Facility Satisfaction Score
Endline
|
22.4 score on a scale
Standard Deviation 4.4
|
22.5 score on a scale
Standard Deviation 4.7
|
23.0 score on a scale
Standard Deviation 4.3
|
PRIMARY outcome
Timeframe: Baseline, at the end of 12-month intervention (Endline)The measure of community empowerment is a 4 item scale with answers on a 5 point Likert scale. Possible scores range from 4 to 20. Higher scores reflect greater community empowerment. The measure of community empowerment is implemented in the women's individual-level questionnaire in the pre- and post-intervention surveys.
Outcome measures
| Measure |
Community Score Card
n=1650 Participants
In the Community Score Card approach, community members come together to document challenges they encounter when seeking services and develop a corresponding set of indicators that can be used to produce a validated facility score. The score is shared with the community and a collaborative process between key community members and facility staff takes place to develop feasible solutions and a strategic action plan.
|
Citizen Report Card
n=1685 Participants
In the Citizen Report Card approach, individual-level feedback is collected from actual clients of target facilities, via a structured questionnaire, to assess facility performance and generate a public record of service quality. In addition to sharing the final report card with communities, engaged policymakers are invited to use the citizen feedback to improve service delivery.
|
Control
n=1650 Participants
Communities in the control arm will not receive an intervention.
|
|---|---|---|---|
|
Mean Community Empowerment Score
Baseline
|
9.9 score on a scale
Standard Deviation 3.9
|
10.0 score on a scale
Standard Deviation 3.8
|
10.4 score on a scale
Standard Deviation 4.1
|
|
Mean Community Empowerment Score
Endline
|
9.8 score on a scale
Standard Deviation 4.1
|
10.0 score on a scale
Standard Deviation 4.5
|
10.0 score on a scale
Standard Deviation 4.1
|
PRIMARY outcome
Timeframe: Baseline, 12 monthsThere are three indicators measuring community involvement: In the last 12 months, have you 1. been an active member in any organized group in your community, for example a women's group, a religious group, or other community group? 2. received help from any organized group in your community, for example a women's group, a religious group, or other community group? Help could include emotional support, economic assistance, or helping you to learn or do things. 3. joined together with other people in your community to improve health services for women or children? All indicators have a binary response option (Yes/No). A value of 1 was assigned to all affirmative responses and created a scale (0-3). Higher scores reflect more community involvement.
Outcome measures
| Measure |
Community Score Card
n=1650 Participants
In the Community Score Card approach, community members come together to document challenges they encounter when seeking services and develop a corresponding set of indicators that can be used to produce a validated facility score. The score is shared with the community and a collaborative process between key community members and facility staff takes place to develop feasible solutions and a strategic action plan.
|
Citizen Report Card
n=1685 Participants
In the Citizen Report Card approach, individual-level feedback is collected from actual clients of target facilities, via a structured questionnaire, to assess facility performance and generate a public record of service quality. In addition to sharing the final report card with communities, engaged policymakers are invited to use the citizen feedback to improve service delivery.
|
Control
n=1650 Participants
Communities in the control arm will not receive an intervention.
|
|---|---|---|---|
|
Mean Community Involvement
Baseline
|
1.3 score on a scale
Standard Deviation 1.1
|
1.3 score on a scale
Standard Deviation 1.1
|
1.3 score on a scale
Standard Deviation 1.1
|
|
Mean Community Involvement
Endline
|
1.4 score on a scale
Standard Deviation 1.0
|
1.4 score on a scale
Standard Deviation 1.0
|
1.4 score on a scale
Standard Deviation 1.1
|
PRIMARY outcome
Timeframe: Baseline, at the end of 12-month intervention (Endline)Perceived quality of family planning service delivery is measured via 20 survey questions with different answer options, ranging from binary to four response options. All but two of the 20 variables were binary yes/no (0/1) response options; the remaining two variables were initially variables with four response options that were collapsed to binary response options (0/1). Possible scores range from 0 to 20. Higher scores reflect greater perceived quality of family planning service delivery. The measure of perceived quality is implemented in the women's individual-level questionnaire in the pre- and post-intervention surveys.
Outcome measures
| Measure |
Community Score Card
n=1650 Participants
In the Community Score Card approach, community members come together to document challenges they encounter when seeking services and develop a corresponding set of indicators that can be used to produce a validated facility score. The score is shared with the community and a collaborative process between key community members and facility staff takes place to develop feasible solutions and a strategic action plan.
|
Citizen Report Card
n=1685 Participants
In the Citizen Report Card approach, individual-level feedback is collected from actual clients of target facilities, via a structured questionnaire, to assess facility performance and generate a public record of service quality. In addition to sharing the final report card with communities, engaged policymakers are invited to use the citizen feedback to improve service delivery.
|
Control
n=1650 Participants
Communities in the control arm will not receive an intervention.
|
|---|---|---|---|
|
Mean Perceived Quality of Family Planning Service Delivery Score
Baseline
|
17.3 score on a scale
Standard Deviation 2.3
|
17.4 score on a scale
Standard Deviation 2.2
|
17.3 score on a scale
Standard Deviation 2.6
|
|
Mean Perceived Quality of Family Planning Service Delivery Score
Endline
|
17.0 score on a scale
Standard Deviation 2.6
|
17.1 score on a scale
Standard Deviation 2.5
|
17.1 score on a scale
Standard Deviation 2.5
|
PRIMARY outcome
Timeframe: Baseline, 12 monthsThe measure of absenteeism is a binary variable obtained using a roster of healthcare providers to assess provider absence. Response options for each provider include Yes and No and up to 10 providers at each facility will be assessed for absence. The percent of providers absent will be measured by taking the number of providers absent and dividing by the total number of providers listed on the roster. The percent change in absenteeism is calculated by subtracting the baseline from the endline and dividing by the baseline. The measure of provider absenteeism is implemented in the facility-level unannounced visitor questionnaire in the pre- and post-intervention surveys. Enumerators took attendance, using a pre-obtained roster of all scheduled healthcare providers, on the day of data collection. Not all healthcare providers were enrolled/interviewed. No non-provider staff were enrolled.
Outcome measures
| Measure |
Community Score Card
n=283 Participants
In the Community Score Card approach, community members come together to document challenges they encounter when seeking services and develop a corresponding set of indicators that can be used to produce a validated facility score. The score is shared with the community and a collaborative process between key community members and facility staff takes place to develop feasible solutions and a strategic action plan.
|
Citizen Report Card
n=282 Participants
In the Citizen Report Card approach, individual-level feedback is collected from actual clients of target facilities, via a structured questionnaire, to assess facility performance and generate a public record of service quality. In addition to sharing the final report card with communities, engaged policymakers are invited to use the citizen feedback to improve service delivery.
|
Control
n=263 Participants
Communities in the control arm will not receive an intervention.
|
|---|---|---|---|
|
Percent Change in Provider Absenteeism
|
-5.9 percent change in providers absent
|
15.2 percent change in providers absent
|
-8.3 percent change in providers absent
|
PRIMARY outcome
Timeframe: Baseline, 12 monthsPopulation: Each facility was observed by 3 different mystery clients at both Baseline and Endline. The 3 observations per facility do not necessarily represent 3 different providers. No identifying information was collected from any provider observed by a mystery client. The Overall Number of Participants shown above reflect mystery client observations.
The Method Information Index Plus (MII+) consists of four indicators: "Were you informed about other methods?" "Were you informed about side effects?" "Were you told what to do if you experienced side effects?" "Were you told about the possibility of switching to another method if the method you selected was not suitable?" The reported value is the percentage of mystery client (MC) observations in which the mystery client answered in the affirmative for all four indicators in the index. The percent change in affirmative observations is calculated by subtracting the baseline from the endline and dividing by the baseline. MII+ is measured in the mystery client observation guide in the pre- and post-intervention surveys. Highly experienced, well-trained data collectors served as mystery clients. These enumerators were part of the study team and not participants who signed informed consent.
Outcome measures
| Measure |
Community Score Card
n=270 Participants
In the Community Score Card approach, community members come together to document challenges they encounter when seeking services and develop a corresponding set of indicators that can be used to produce a validated facility score. The score is shared with the community and a collaborative process between key community members and facility staff takes place to develop feasible solutions and a strategic action plan.
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Citizen Report Card
n=276 Participants
In the Citizen Report Card approach, individual-level feedback is collected from actual clients of target facilities, via a structured questionnaire, to assess facility performance and generate a public record of service quality. In addition to sharing the final report card with communities, engaged policymakers are invited to use the citizen feedback to improve service delivery.
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Control
n=276 Participants
Communities in the control arm will not receive an intervention.
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|---|---|---|---|
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Percent Change in the Number of Mystery Client Observations of Providers in Which the Mystery Client Answered in the Affirmative to the Full Method Information Index Plus (MII+)
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-22.8 percent change
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-67.0 percent change
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-64.1 percent change
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PRIMARY outcome
Timeframe: Baseline, 12 monthsPopulation: Each facility was observed by 3 different mystery clients at both Baseline and Endline. The 3 observations per facility do not necessarily represent 3 different providers. No identifying information was collected from any provider observed by a mystery client. The Overall Number of Participants shown above reflect mystery client observations of providers.
The measure of informal payment solicitation is a binary variable obtained by asking mystery clients whether they were asked by facility staff to pay when seeking family planning services at a public-sector healthcare facility. Response options include Yes and No. The percent of mystery client visits in which an informal payment is solicited will be measured by taking the number of mystery client visits for which an informal fee is solicited and dividing by the total number of mystery client visits. The percent change in mystery client observations with informal payment solicitation is calculated by subtracting the baseline from the endline and dividing by the baseline.The measure of informal payments is implemented in the mystery client questionnaire in the pre- and post-intervention surveys. Highly experienced, well-trained data collectors served as mystery clients. These enumerators were part of the study team and not participants who signed informed consent.
Outcome measures
| Measure |
Community Score Card
n=270 Participants
In the Community Score Card approach, community members come together to document challenges they encounter when seeking services and develop a corresponding set of indicators that can be used to produce a validated facility score. The score is shared with the community and a collaborative process between key community members and facility staff takes place to develop feasible solutions and a strategic action plan.
|
Citizen Report Card
n=276 Participants
In the Citizen Report Card approach, individual-level feedback is collected from actual clients of target facilities, via a structured questionnaire, to assess facility performance and generate a public record of service quality. In addition to sharing the final report card with communities, engaged policymakers are invited to use the citizen feedback to improve service delivery.
|
Control
n=276 Participants
Communities in the control arm will not receive an intervention.
|
|---|---|---|---|
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Percent Change in Mystery Client Observations With Informal Payment Solicitation
|
-34.0 percent change
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-20.6 percent change
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-25.2 percent change
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PRIMARY outcome
Timeframe: Baseline, 12 monthsPopulation: Facilities were observed by 3 different mystery clients at both Baseline and Endline. The 3 observations per facility do not necessarily represent 3 different providers. No identifying information was collected from any provider observed by a MC. The Overall Number of Participants shown above reflect MC observations of providers. The percent change in MC observations with informal payment solicitation is calculated by subtracting the baseline from the endline and dividing by the baseline.
The measure of patient mistreatment is a binary variable obtained by asking mystery clients "Did your provider do any of the following?" Response options include Shouted at me; Scolded me or treated me with scorn; Threatened to withhold services; Called me by an insulting name; Laughed at me; Other type of disrespect, please explain. If the mystery client selects any of the response options, patient mistreatment is identified. The percent of mystery client visits in which patient mistreatment occurs will be measured by taking the number of mystery client visits for which mistreatment occurs and dividing by the total number of mystery client visits. The measure of patient mistreatment is implemented in the mystery client questionnaire in the pre- and post-intervention surveys. Highly experienced, well-trained data collectors served as mystery clients. These enumerators were part of the study team and not participants who signed informed consent.
Outcome measures
| Measure |
Community Score Card
n=270 Participants
In the Community Score Card approach, community members come together to document challenges they encounter when seeking services and develop a corresponding set of indicators that can be used to produce a validated facility score. The score is shared with the community and a collaborative process between key community members and facility staff takes place to develop feasible solutions and a strategic action plan.
|
Citizen Report Card
n=276 Participants
In the Citizen Report Card approach, individual-level feedback is collected from actual clients of target facilities, via a structured questionnaire, to assess facility performance and generate a public record of service quality. In addition to sharing the final report card with communities, engaged policymakers are invited to use the citizen feedback to improve service delivery.
|
Control
n=276 Participants
Communities in the control arm will not receive an intervention.
|
|---|---|---|---|
|
Percent Change in the Number of Mystery Client Observations Identifying Patient Mistreatment
|
53.2 percent change mistreatment observations
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161.9 percent change mistreatment observations
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118.4 percent change mistreatment observations
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PRIMARY outcome
Timeframe: Baseline, at the end of 12-month intervention (Endline)The CTC provider motivation indicator scale is a 12 item scale. Answers are on a 5 point Likert scale. Possible scores range from 12 to 60. Higher scores reflect greater provider motivation. The measure of provider motivation is implemented in the facility-level provider's questionnaire in the pre- and post-intervention surveys.
Outcome measures
| Measure |
Community Score Card
n=254 Participants
In the Community Score Card approach, community members come together to document challenges they encounter when seeking services and develop a corresponding set of indicators that can be used to produce a validated facility score. The score is shared with the community and a collaborative process between key community members and facility staff takes place to develop feasible solutions and a strategic action plan.
|
Citizen Report Card
n=258 Participants
In the Citizen Report Card approach, individual-level feedback is collected from actual clients of target facilities, via a structured questionnaire, to assess facility performance and generate a public record of service quality. In addition to sharing the final report card with communities, engaged policymakers are invited to use the citizen feedback to improve service delivery.
|
Control
n=229 Participants
Communities in the control arm will not receive an intervention.
|
|---|---|---|---|
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Mean Close-to-Community (CTC) Provider Motivation Indicator Score
Baseline
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17.9 score on a scale
Standard Deviation 4.3
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17.4 score on a scale
Standard Deviation 4.3
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18.3 score on a scale
Standard Deviation 4.9
|
|
Mean Close-to-Community (CTC) Provider Motivation Indicator Score
Endline
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18.4 score on a scale
Standard Deviation 4.7
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18.5 score on a scale
Standard Deviation 4.6
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17.8 score on a scale
Standard Deviation 4.5
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Adverse Events
Community Score Card
Citizen Report Card
Control
Serious adverse events
Adverse event data not reported
Other adverse events
Adverse event data not reported
Additional Information
Emilia Goland, MMSc
University of North Carolina at Chapel Hill
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place