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NCT07200323
Postpartum depression (PPD) is a frequent complication of the postnatal period but remains underdetected in routine clinical practice. This prospective clinical study, conducted at the high-risk pregnancy clinic of the CHUM, aims to estimate the prevalence of PPD among patients seen in postpartum follow-up. It also assesses the feasibility of implementing a standardized screening protocol that combines the administration of the Edinburgh Postnatal Depression Scale (EPDS) with a clinical decision-support algorithm to guide appropriate medical follow-up. The study also seeks to explore clinical characteristics associated with higher EPDS scores.
NCT06349070
The study will apply the principles of Community Based Participatory Research to evaluate implementation strategies, designed to assist in the delivery of an evidence-based lifestyle counseling intervention for pregnant participants. The primary strategies include a technology supported strategy (low touch) in which text messaging and online videos are used for asynchronous viewing compared to a Community Health Worker-led synchronous (group and individual) strategy (high touch). Prior to implementation, one-time interview and focus groups will be conducted with clinic providers and staff. In addition, a subsample of subjects will be enrolled into a prospective cohort to complete a survey during pregnancy and a survey postpartum. The aims of the study are 1) to evaluate and compare adoption of the program delivery with text technology messaging vs. delivery by Community Health Workers (CHW), 2) to examine implementation fidelity , 3) to evaluate and compare the impact of the strategies on key clinical outcomes, 4) to examine sustainability (continued adoption) following the CHW-led strategy implementation period and conduct an economic evaluation of the two-implementation strategies.
NCT03228875
Early life exposures may lead to adverse effects on health in later life. The Boston birth Cohort study is designed to study a broad array of early life factors and their effects on maternal and child health outcomes.
NCT07133321
This study aims to improve the health and safety of mothers during pregnancy and childbirth by working closely with their husbands. In many communities in Ethiopia, husbands play an important role in decisions about where women give birth. The study involves educating husbands in group sessions to help them understand how to support their wives during pregnancy, prepare for childbirth, recognize danger signs, and encourage giving birth in health centers where skilled care is available. At the same time, some health workers receive training to improve their ability to handle childbirth emergencies and provide respectful, culturally sensitive care. Communities are divided into groups that receive either husband education, health worker training, both, or no additional support. The study will see which approach helps more women deliver safely in health centers and receive care after birth. By involving husbands and improving health worker skills, this study hopes to support mothers better and improve outcomes for families.
NCT05019131
The activities described in this proposal are aimed at addressing health care provider stress and unconscious bias to improve quality of maternal health care, particularly related to the person-centered dimensions of care-i.e. care that is respectful and responsive to women's needs, preferences, and values. The investigators focus on health provider stress and unconscious bias because they are key drivers of poor-quality care that are often not addressed in interventions designed to improve quality of maternal health care. The investigators plan to (1) design an intervention that enables providers to identify and manage their stress and unconscious bias; (2) pilot the intervention to assess its feasibility and acceptability; and (3) assess preliminary effect of the intervention on: (a) provider knowledge, attitudes, and behaviors related to stress and unconscious bias; and (b) provider stress levels.
NCT06677281
This systematic review aims to evaluate the impact of COVID-19 on pregnancy outcomes. It synthesizes data from various studies to provide insights into the effects of the virus on maternal and fetal health. The review focuses on key outcomes such as preterm birth, maternal complications, and neonatal health, utilizing comprehensive literature from peer-reviewed journals. By analyzing existing studies, we aim to identify trends and gaps in research regarding COVID-19 and pregnancy. This review is intended to inform healthcare providers and pregnant individuals about potential risks and considerations during the pandemic.
NCT05916534
The goal of this clinical trial is to test a behavioral intervention in pregnant women who identify as Black and live in Central Brooklyn. The main question it aims to answer is whether the WeCAB intervention leads to a net improvement in utilization of postpartum care compared to those receiving usual care. The WeCAB group will have a dedicated WeCAB community health worker who will be trained in digital care navigation. Researchers will compare the WeCAB group versus the group receiving usual care to see if the patients randomized to WeCAB will have higher rates of early post-partum care compared to patients in the control group.
NCT05716178
Community education and demand generation activities by involving family members, traditional and religious leaders in maternal health behaviours are potential solutions. Knowledge about maternal and neonatal health service utilization can be increased through community-based structures, such as religious organizations.
NCT03189004
1. Burden: In global perspective, it is estimated that the lives of 150,000 women could be saved each year worldwide with access to sufficient family planning services. It is indicated that only 26 percent women received four or more antenatal care (ANC) visits during their pregnancies, while 67.7 percent received at least one ANC during their pregnancies which are the great challenges for ensuring safe motherhood in the country. As a part of safe motherhood, it is estimated that only 28.8 percent deliveries are being conducted in health facilities in the country. In case of postnatal care (PNC), from 2008 to 2010, only 27 percent of women received PNC for their last deliveries from a medically-trained provider within two days of their delivery. Despite the tremendous success of expanded programme on immunization (EPI) in Bangladesh, a substantial number of children are not fully vaccinated under EPI as data shows 82 percent were fully vaccinated by the age of 12 months. 2. Knowledge gap: Use of technology for covering all or major components of primary health care (PHC) is yet to be developed and tested in Bangladesh. Further, no such initiative has yet been taken focusing community clinic (CC) to ensure equity of services in Bangladesh. 3. Relevance: At present in Bangladesh, the CCs cater the services on family planning, maternal neonatal and child health (MNCH), health education for the rural people by using e-health strategy as the community health care provider (CHCP), newly recruited staff of community clinic are equipped with internet connected laptop service. So, updated technology for updating information, follow up and referral in primary health care can be used to increase the utilization of health services. Hypothesis (if any): Use of smart phones by community level healthcare providers will increase utilization of reproductive health (RH) and family planning (FP), MNCH, integrated management of childhood illness (IMCI), EPI and other PHC services at rural communities in Bangladesh. Objectives: To develop and test a mechanism as well as assess the impact of mHealth strategy to improve RH and FP, MNCH, IMCI, EPI and other PHC services in rural communities of Bangladesh. Methods: The service delivery personnel who are providing the services to the community people at different levels (community clinic, union health and family welfare centre, upazila health complex) will be equipped with smart phones having the facilities for text messages, voice messages as well as internet and data capturing. Training on handling of the smart phones, data capturing and monitoring will be provided to service providers in each upazila. They will be trained to input, edit, verify and monitor the data on different services through the software installed in their smart phones. The community clinic management and support groups will be oriented and motivated on mobile phone based registration, notification and referral to the health facilities. Outcome measures/variables: This will be a quasi-experimental pre-post design study and evaluation will be done through comparing antenatal care (ANC), postnatal care (PNC), and contraceptive prevalence rate (CPR) and EPI coverage before and after its implementation in the study versus comparison areas. The study will be conducted over a period of 30 months.
NCT04039932
In 2015, the average Ethiopian woman had a 1 in 64 lifetime risk of death due to complications of childbirth and 87,414 newborns died before their 28th day of life. Demand for MNCH services, however, remains low in Ethiopia's rural communities most at risk with only 16% of women delivering in a health facility. The investigator's project responds to the challenge of creating demand for existing MNCH services in rural Ethiopia, which fell short of reaching Millennium Development Goal targets for reducing preventable maternal and neonatal deaths. This study addresses two strategic drivers to prevent maternal mortality identified by USAID including improving individual, household, and community behaviors and norms and increasing equity of access and use of services by the most vulnerable. The primary objective of the study is to determine the impact of a behavior change intervention that partners Ethiopian Orthodox priests with members of the Health Development Army (HDA) and trains them to conduct maternal health outreach to increase births attended by skilled health personnel among women who attend ≥1 ANC visits.
NCT03145571
To validate a model of Continuity of Midwifery Care implemented in the region of Nabuls and Jericho in Palestine in 2013, register data from the Palestinian Ministry of Health will be analyzed for the following indicators related to usage and quality. Changes in these variables before and after the implementation will be compared between the 16 clinics where the model was implemented and all comparable clinics in the region.
NCT01821222
Reducing maternal and newborn mortality remains a global challenge. Because obstetric complications cannot be predicted, skilled attendance at the time of delivery and access to emergency obstetric care remain the most effective strategies to reduce mortality. Antenatal care has the potential to reduce maternal morbidity and improve newborns survival but this benefit may not be realized in sub-Saharan Africa where the attendance and quality of care is declining. There is a rapidly expanding number of mobile phone users in developing countries and due to the potential to strengthen health system the use of mobile phones is health care is emerging. The investigators assessed a mobile phone intervention named "wired mothers" aimed to improve maternal and newborn health. The hypothesis of the study was that the wired mothers mobile phone intervention would increase attendance to essential reproductive health services such as antenatal care and skilled delivery attendance and reduce severe adverse pregnancy outcomes for women and newborn. The objective of the study was to examine the effect of the wired mothers intervention on antenatal care, skilled delivery attendance, access to emergency obstetric care and perinatal mortality. The study was a pragmatic cluster randomized controlled trial with the primary health care facility as the unit of randomization. The study took place in 2009-2010 on the island of Unguja in Zanzibar. 2550 pregnant women who attended antenatal care at one of 24 selected facilities were included at their first visit and followed until 42 days after delivery. Facilities were allocated by simple randomization to either mobile phone intervention (n=12) or standard care (n=12). The intervention consisted of a SMS and mobile phone voucher component. The perspectives of the study are that mobile phones may contribute to saving the lives of women and their newborns and achievement of MDGs 4 and 5. Evidence is needed to guide maternal and child health policy makers in developing countries.