The Added Value of Midwifes to Prenatal, Natal, and Postnatal Care in Bolivia

Last registered on January 29, 2021

Pre-Trial

Trial Information

General Information

Title
The Added Value of Midwifes to Prenatal, Natal, and Postnatal Care in Bolivia
RCT ID
AEARCTR-0007104
Initial registration date
January 29, 2021
Last updated
January 29, 2021, 1:26 PM EST

Locations

There are documents in this trial unavailable to the public. Use the button below to request access to this information.

Request Information

Primary Investigator

Affiliation
Pontificia Universidad Catolica de Chile

Other Primary Investigator(s)

PI Affiliation
3ieImpact

Additional Trial Information

Status
In development
Start date
2020-01-01
End date
2022-12-31
Secondary IDs
Abstract
The role of continuing care through pregnancy may yield important health effects on birth-related outcomes. This study will investigate the effect of enhancing primary care clinics with midwives on outcomes related to prenatal, natal, and postnatal care. We implement a randomized phased-in of assignment of midwives to primary care centers in municipalities in Bolivia. This is done in the context of a government project to improve the public health network of the country by investing in primary care, hospitals, infrastructure, human resources, and IT systems. We will use administrative records and surveys to gather information on final outcomes.
External Link(s)

Registration Citation

Citation
Celhay, Pablo and Sebastian Martinez. 2021. "The Added Value of Midwifes to Prenatal, Natal, and Postnatal Care in Bolivia ." AEA RCT Registry. January 29. https://doi.org/10.1257/rct.7104-1.0
Experimental Details

Interventions

Intervention(s)
In this study, we will evaluate a program that equalizes the ratio of the number of midwives to the population in 53 municipalities in Bolivia. To do this, the program will randomly allocate midwives to municipalities in three different phases.
Intervention Start Date
2020-01-01
Intervention End Date
2022-12-31

Primary Outcomes

Primary Outcomes (end points)
1. Utilization of prenatal care services: number of visits and weeks pregnant at first visit.
2. Birth delivery: weeks pregnant at birth, place of delivery, type of delivery (institutional or not), type of birth (c-section or vaginal), death at birth (child or mother), birth weight, Apgar score.
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
1. Fertility: Number of children, different in age between children, use of contraception methods.
2. Mediators: beliefs about contraception, saliency of the importance of prenatal care.
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
To answer these questions we are implementing a randomized control Trial (RCT) that randomly allocates midwives to different health municipalities in order to balance the number of midwives per 1,000 habitants in 53 municipalities in Bolivia. To do this we separated municipalities into three groups that will hire midwives in different years starting with the first group is 2019, the second group in 2020, and the third group in 2021. This method is suitable to control for several unobserved factors that could affect outcomes and the probability of enhancing health networks with midwife services such as, municipality income, the relative efficiency of primary care, and other health demand or supply factors particular to municipalities in the sample.
Experimental Design Details
Not available
Randomization Method
Randomization was done in-office using Stata(R).
Randomization Unit
Municipality
Was the treatment clustered?
Yes

Experiment Characteristics

Sample size: planned number of clusters
53 municipalities
Sample size: planned number of observations
200 pregnancies/births per cluster
Sample size (or number of clusters) by treatment arms
53 municipalities with an average size of 200
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
The minimum detectable effects size computed is 0.15 standard deviations
IRB

Institutional Review Boards (IRBs)

IRB Name
IRB Approval Date
IRB Approval Number
Analysis Plan

There are documents in this trial unavailable to the public. Use the button below to request access to this information.

Request Information