The effect of report cards on the coverage of maternal and neonatal health care: a factorial, cluster-randomised controlled trial in Uttar Pradesh, India.

摘要: Summary Background Report cards are a prominent strategy to increase the ability of citizens express their view, improve public accountability, and foster community participation in provision health services low-income middle-income countries. In India, social accountability interventions that incorporate report meetings have been implemented at scale, attracting considerable policy attention, but there is little evidence on effectiveness improving health. We aimed evaluate effect cards, which contain information village-level indicators maternal neonatal care, participatory targeted providers members (including local leaders) coverage care Uttar Pradesh, India. Methods conducted repeated cross-sectional, 2 × 2 factorial, cluster-randomised controlled trial, each cluster was village (rural) or ward (urban). The clusters were randomly assigned one four groups: provider group, we shared held with services; leaders); both community; control not anyone. generated these by collating data from household surveys recipients (as determined groups) meetings. primary outcome proportion women who had least antenatal visits (ie, attended clinic visited home health-care worker) during last pregnancy. measured outcomes cross-sectional taken baseline, first follow-up (after 8 months intervention), second (21 after start intervention). Analyses intention treat. This trial registered ISRCTN, number ISRCTN11070792. Findings surveyed eligible for baseline survey between Jan 13, Feb 5, 2015. then 44 45 group. collated provided recipient groups, as per random allocation, October, 2015, September, 2016. ran May 16 June 10, 18 July 18, 2017. 3133 (795 781 798 759 group) gave birth implementation intervention, 1, 2016, 2017 (the end survey). card intervention did significantly affect (provider vs non-provider: odds ratio 0·85, 95% CI 0·65–1·13; non-community: 0·86, 0·65–1·13). Interpretation Maternal containing performance, either providers, no detectable care. Future research should seek understand how content delivery success this type intervention. Funding Merck Sharp Dohme.