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Female voices, community choices: a randomized controlled trial to evaluate female-only Community Monitoring meetings
Last registered on May 19, 2017

Pre-Trial

Trial Information
General Information
Title
Female voices, community choices: a randomized controlled trial to evaluate female-only Community Monitoring meetings
RCT ID
AEARCTR-0002225
Initial registration date
May 19, 2017
Last updated
May 19, 2017 5:52 PM EDT
Location(s)
Region
Primary Investigator
Affiliation
Harvard School of Public Health
Other Primary Investigator(s)
Additional Trial Information
Status
On going
Start date
2016-12-05
End date
2018-06-30
Secondary IDs
Abstract
Community monitoring of health services is an intervention designed to help communities reach consensus on areas of health service provision that need improvement, and to monitor the progress of underperforming health care providers. In December 2016, community monitoring was scaled-up in four health districts in North West (NW) Cameroon. The 84 health facilities included in the scale-up were randomized into two groups. The standard community monitoring protocol in which both men and women are invited to community meetings was implemented in the first 42 health facilities. In the second group of 42 facilities, only women from the community were invited to participate. During each community meeting, five health system indicators are selected as health system improvement priorities. The primary outcome that will be assessed from the randomized community monitoring study is whether the priorities selected in meetings containing only women are more consistent with women’s health service improvement priorities than those selected in mixed-gender meetings. Gender priorities will be assessed using a household survey, which will ask men and women to list their top five health priorities. We will also assess whether women’s health service use increases in communities where women’s only community meetings were conducted relative to the change in health services observed in communities where standard community monitoring took place.
External Link(s)
Registration Citation
Citation
Steenland, Maria. 2017. "Female voices, community choices: a randomized controlled trial to evaluate female-only Community Monitoring meetings." AEA RCT Registry. May 19. https://doi.org/10.1257/rct.2225-1.0.
Former Citation
Steenland, Maria. 2017. "Female voices, community choices: a randomized controlled trial to evaluate female-only Community Monitoring meetings." AEA RCT Registry. May 19. http://www.socialscienceregistry.org/trials/2225/history/17818.
Experimental Details
Interventions
Intervention(s)
In December 2016, community monitoring was scaled-up in four health districts in North West (NW) Cameroon. The 84 health facilities included in the scale-up were randomized into two groups. The standard community monitoring protocol in which both men and women are invited to community meetings was implemented in the first 42 health facilities. In the second group of 42 facilities, only women from the community were invited to participate. The community monitoring process begins with a community meeting during which community members discuss the health issues that are most important to the community, prioritize health services for improvement and identify indicators that can be used to measure progress. To form representative community meetings, community groups are tasked with selecting attendees from all of the zones served by the health facility. During each community meeting, five health system indicators are selected as health system improvement priorities. Every three months after the initial meeting, community representatives reconvene to assess whether progress on selected indicators has been made, and to provide feedback to health facilities on the community assessment of their performance.
Intervention Start Date
2016-12-05
Intervention End Date
2017-12-31
Primary Outcomes
Primary Outcomes (end points)
Primary outcome: the average gender priority gap in priorities selected during community meetings containing only women compared to the gender priority gap in meetings containing both men and women.
Secondary outcome: the change in use of maternal and child health services over the study period in facilities where women’s only meetings were conducted compared to the change in standard community monitoring facilities. We will use facility-level administrative data to assess health service provision.
Primary Outcomes (explanation)
Male and female health service priorities will be assessed using a household survey, which will ask male and female respondents to list the top five things they would like to see improved in their local health facility. Using this data, we will first calculate the percent of men and women selecting each priority, and then subtract these two percentages to obtain the difference. This difference will be then applied as a weight to all of the priorities selected during the community meetings. The sum of the weighted priorities will be considered the outcome of interest (the gender priority gap).
Secondary Outcomes
Secondary Outcomes (end points)
Secondary Outcomes (explanation)
Experimental Design
Experimental Design
Eighty-four health facilities starting Community Monitoring in North West Cameroon in December 2016 were randomized into two groups. The standard community monitoring protocol in which both men and women are invited to community meetings was implemented in the first 42 health facilities. In the second group of 42 facilities, only women from the community were invited to participate.
Experimental Design Details
Eighty-four health facilities starting Community Monitoring in North West Cameroon in December 2016 were randomized into two groups. The standard community monitoring protocol in which both men and women are invited to community meetings was implemented in the first 42 health facilities. In the second group of 42 facilities, only women from the community were invited to participate.
Randomization Method
Stata
Randomization Unit
Health facility
Was the treatment clustered?
No
Experiment Characteristics
Sample size: planned number of clusters
Randomization was done at the health facility level
Sample size: planned number of observations
Five meetings from 84 health facilities will be included in this study.
Sample size (or number of clusters) by treatment arms
42 health facilities in the control group; 42 health facilities in the intervention group
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
IRB
INSTITUTIONAL REVIEW BOARDS (IRBs)
IRB Name
Regional Hospital Institutional Review Board, North West Cameroon
IRB Approval Date
2016-12-13
IRB Approval Number
None
IRB Name
Harvard School of Public Health
IRB Approval Date
2016-10-27
IRB Approval Number
IRB16-1723
Post-Trial
Post Trial Information
Study Withdrawal
Intervention
Is the intervention completed?
No
Is data collection complete?
Data Publication
Data Publication
Is public data available?
No
Program Files
Program Files
Reports, Papers & Other Materials
Relevant Paper(s)
REPORTS & OTHER MATERIALS