Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
NA
1500 participants
INTERVENTIONAL
2024-01-20
2024-08-30
Brief Summary
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Detailed Description
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In South Africa, the health system is characterised by stark inequalities, with most of the population only able to seek care in free government facilities. The low quality of the public sector, where patients wait long times to be seen by nurses, is believed to lead many to delay needed care and prevent health outcome improvement. The government of South Africa is developing proposals to introduce a national health insurance scheme that would provide free access to private providers who deliver higher care quality. However, concerns about the unequal geographical distribution of private providers raise questions about the potential benefits of the reform. This study asks several questions to inform this reform:
1. Does access to higher-quality care reduce under-use of services for children but also increase overuse?
2. Does access to higher-quality care lead to improved health knowledge of parents and better health outcomes for children?
3. Are these effects mitigated by the distance to the contracted providers? A randomised controlled trial is used to answer these questions. The study will recruit about 1,500 individuals who are the primary caregiver of at least one child aged six or under. and randomly allocate them to a control group (CONTROL) with the default free access to government facilities or one of the two treatment groups where they will have free access to private providers located either relatively close (CONVENIENT) by or relatively far (INCONVENIENT).
The primary outcomes will be the proportion of visits that are considered unnecessary (overuse) and the number of days of illness where care-seeking is recommended by guidelines but not sought by the child's parent or guardian.
Secondary outcomes will include (1) the number of days with ill-health symptoms; (2) out-of-pocket expenditures; (3) health knowledge of parents; (4) subjective and (5) objective measures of child's health.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
HEALTH_SERVICES_RESEARCH
SINGLE
Study Groups
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Control group
In this group, participants will have free access to government facilities (usual care)
No interventions assigned to this group
Convenient group
In this group, for the duration of the study, participants will be given free access to a small number of private providers located relatively close by (less than 30 minutes).
Free high-quality care
Participants are able to take their child to receive free consultations and treatment in a network of contracted private healthcare providers.
Close distance
The network of contracted providers is located close to where participants live.
Inconvenient group
In this group, for the duration of the study, participants will be given free access to a small number of private providers located relatively far (about one hour).
Free high-quality care
Participants are able to take their child to receive free consultations and treatment in a network of contracted private healthcare providers.
Far distance
The network of contracted providers is located far to where participants live.
Interventions
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Free high-quality care
Participants are able to take their child to receive free consultations and treatment in a network of contracted private healthcare providers.
Close distance
The network of contracted providers is located close to where participants live.
Far distance
The network of contracted providers is located far to where participants live.
Eligibility Criteria
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Inclusion Criteria
Exclusion Criteria
* has private medical aid
2 Months
6 Years
ALL
Yes
Sponsors
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University of Witwatersrand, South Africa
OTHER
London School of Economics and Political Science
OTHER
Responsible Party
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Principal Investigators
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Mylene Lagarde, PhD
Role: PRINCIPAL_INVESTIGATOR
London School of Economics and Political Science
Locations
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HDSS Soweto clusters
Soweto, Gauteng, South Africa
Countries
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Other Identifiers
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SOPRIMA//T023635
Identifier Type: -
Identifier Source: org_study_id
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