Improving the Quality of Private Sector Health Care in West Bengal

Last registered on September 09, 2013

Pre-Trial

Trial Information

General Information

Title
Improving the Quality of Private Sector Health Care in West Bengal
RCT ID
AEARCTR-0000034
Initial registration date
Not yet registered
Last updated
September 09, 2013, 3:38 PM EDT

Locations

Primary Investigator

Affiliation
Harvard Business School

Other Primary Investigator(s)

PI Affiliation
MIT and Jameel Poverty Action Lab
PI Affiliation
World Bank

Additional Trial Information

Status
On going
Start date
2012-09-01
End date
2014-04-01
Secondary IDs
Abstract
The rural healthcare market in much of the developing world, and especially in South Asia, is composed largely of informal private providers. These private providers often have little to no certifiable medical training. Recent studies, using medical vignettes (or hypothetical medical situations) to measure clinical competence and direct observations of doctor-patient interactions to measure clinical practice, highlight the deplorably low standards in rural healthcare. To address such standards, the Liver Foundation in Kolkata, West Bengal over the last two years has been working with private rural health care providers through capacity building activities to improve quality in the private sector. The program consists of multiple-week training to private rural health care providers on the basis of a well-developed curriculum in the district of Birbhum, West Bengal.

This study aims to assess the impact of this training program using a randomized evaluation. We employ medical vignettes, provider diaries, direct observation, and standardized patients to assess how such a training program can effect clinical competence, practice, caseload and case types, and fee structures in the short run. It is worth noting that this study will not be able to capture long run effects, such as general equilibrium price or location changes, on health care for the rural poor.
External Link(s)

Registration Citation

Citation
, , and Reshmaan Hussam. 2013. "Improving the Quality of Private Sector Health Care in West Bengal." AEA RCT Registry. September 09. https://doi.org/10.1257/rct.34-1.0
Sponsors & Partners

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Experimental Details

Interventions

Intervention(s)
Intervention Start Date
2012-10-10
Intervention End Date
2013-12-10

Primary Outcomes

Primary Outcomes (end points)
Clinical knowledge/competence, clinical practice, caseload, patient and medicine fees
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
The experimental design involves an RCT with two arms: the control arm in which providers are left alone and the treatment arm in which providers are offered training classes on basic clinical knowledge and competence. We run a baseline prior to randomization, randomize, have our partner organization (Liver Foundation) administer the treatment (training program), run a midline survey involving provider diaries, and run an endline survey three months after the completion of the training program.
Experimental Design Details
Randomization Method
Randomization was done in the office through a computer program.
Randomization Unit
Individual (provider)
Was the treatment clustered?
No

Experiment Characteristics

Sample size: planned number of clusters
300 providers.
Sample size: planned number of observations
300 providers.
Sample size (or number of clusters) by treatment arms
150 providers in control, 150 providers in treatment.
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
IRB

Institutional Review Boards (IRBs)

IRB Name
Massachusetts Institute of Technology (MIT) IRB
IRB Approval Date
2013-01-24
IRB Approval Number
1209005234

Post-Trial

Post Trial Information

Study Withdrawal

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Intervention

Is the intervention completed?
No
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