Entrepreneurial community health delivery in Uganda: a cluster-randomized controlled trial

Last registered on October 21, 2014
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Pre-Trial

Trial Information

General Information

Title
Entrepreneurial community health delivery in Uganda: a cluster-randomized controlled trial
RCT ID
AEARCTR-0000530
Initial registration date
October 21, 2014

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
October 21, 2014, 7:36 AM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Locations

Country
Uganda
Region

Primary Investigator

Name
Martina Björkman Nyqvist
Affiliation
Stockholm School of Economics
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Other Primary Investigator(s)

PI Name
Andrea Guariso
PI Affiliation
KU Leuven
Contact Investigator
PI Name
David Yanagizawa-Drott
PI Affiliation
John F. Kennedy School of Government, Harvard University
Contact Investigator
PI Name
Jakob Svensson
PI Affiliation
Institute for international Economic Studies, Stockholm University
Contact Investigator

Additional Trial Information

Status
Completed
Start date
2009-08-30
End date
2013-12-20
Keywords
Health
Additional Keywords
Community health worker, Child health, Uganda
JEL code(s)
Secondary IDs
Abstract
Despite improvements in under-five child mortality, an estimated 6.9 million children die from preventable diseases worldwide every year. A majority of these deaths occur in the poorest countries in the world, in areas within countries of underserved populations with inadequate access to basic health services. An increasingly common approach to reach these populations has been Community Health Worker (CHW) programs. However, a systematic review of the evidence indicates mixed results of this approach in reducing child mortality. Whether alternative, financially sustainable, delivery models where CHWs earn a margin on product sales and small performance-based incentives can provide a solution is an open question. In this project, we study a community health worker program in Uganda – the community health promoter (CHP) program – where, in contrast to traditional volunteer-based community health workers, community health promoters operate as micro-entrepreneurs earning an income on the sale of preventive and curative products to keep them motivated and active in the community.
External Link(s)

Registration Citation

Citation
Björkman Nyqvist, Martina et al. 2014. "Entrepreneurial community health delivery in Uganda: a cluster-randomized controlled trial ." AEA RCT Registry. October 21. https://doi.org/10.1257/rct.530
Former Citation
Björkman Nyqvist, Martina et al. 2014. "Entrepreneurial community health delivery in Uganda: a cluster-randomized controlled trial ." AEA RCT Registry. October 21. https://www.socialscienceregistry.org/trials/530/history/2958
Sponsors & Partners
Experimental Details

Interventions

Intervention(s)
Intervention Start Date
2011-01-01
Intervention End Date
2013-12-20

Primary Outcomes

Primary Outcomes (end points)
Primary study outcome is under-five child mortality rate. Secondary study outcomes include community-health worker visits, percentage of children sleeping under a treated mosquito bed net, percentage of households that treat water before drinking it, malaria and diarrhea morbidity among children under 5, malaria diarrhea cases promptly treated, percentage of children under 5 receiving Vitamin A supplementation, percentage of deliveries in health facilities, follow up visits after malaria or diarrhea cases, antenatal care visits, follow up visits and delivery, health knowledge.
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
A cluster-randomized controlled trial from 214 rural villages in 10 districts in Uganda. In treatment villages, Living Goods and BRAC Community Health Promoters conducted home visits, educated households on essential health behaviors and sold preventive and curative health products at 5-30% below prevailing retail prices over a three-year period (2011- 2013). On average, around 38 households were surveyed per village at the end of 2013, for a total sample size of roughly 8100 households.
Experimental Design Details
Randomization Method
Randomization done in office by computer
Randomization Unit
Community Health Worker potential catchment area (essentially village)
Was the treatment clustered?
Yes

Experiment Characteristics

Sample size: planned number of clusters
214 Community Health Worker (CHW) potential catchment areas (roughly villages)
Sample size: planned number of observations
8100
Sample size (or number of clusters) by treatment arms
115 Intervention clusters (roughly 4400 Households surveyed), 99 Control clusters (roughly 3700 Households surveyed)
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
Supporting Documents and Materials
IRB

Institutional Review Boards (IRBs)

IRB Name
Uganda National Council for Science and Technology (UNCST) IRB
IRB Approval Date
2013-08-27
IRB Approval Number
SS 3195
IRB Name
IRB of the Harvard School of Public Health
IRB Approval Date
2011-08-23
IRB Approval Number
20141-101
Analysis Plan

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