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Maternal and Child HealthNCT02726230

Bihar Family Health Initiative (Ananya)

A study testing Ananya in people with Maternal and Child Health, run by University of California, San Diego.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Ananya was funded by BMGF to reduce maternal, newborn, and child mortality; fertility; and child undernutrition in Bihar, India. Ananya involved multi-level interventions designed to build front line health worker (FLW) capacities and reach to communities and households, as well as to strengthen public health… Read more about this study

Who is it for?
Ages 15 years and older, women onlyHealthy volunteers can take part
Conditions the study is for
Maternal and Child Health
What is being tested?
Ananya
Could I receive a placebo?
No, everyone receives an active treatment
How many people
27,633 participants
Where
No sites listed yet
Study dates
Jan 2012to Apr 2014
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 15 years and older
  • Women only
  • Healthy volunteers accepted
  • Child, Adult, Older adult

Who may be able to join

  • Mothers of infants 0-23 months residing in the catchment area of the subcenters (public health facilities) included in this study.

Who cannot join

None listed.

About this study

Ananya was funded by BMGF to reduce maternal, newborn, and child mortality; fertility; and child undernutrition in Bihar, India. Ananya involved multi-level interventions designed to build front line health worker (FLW) capacities and reach to communities and households, as well as to strengthen public health facilities and quality of care to increase maternal and neonatal care and health behaviors, and thus survival. From 2012 to 2014, eight focal districts in western and central Bihar.received Ananya, while 30 districts did not. Data were collected from mothers of infants 0-11 months at baseline and mothers of infants 0-23 months at 2 year follow-up, from comparable public health blocks in Ananya and Control districts to assess Ananya effects on quality and quantity of FLW home visits, postnatal health behaviors, and among older infants/toddlers, complementary feeding and vaccination. Difference in difference analyses were used to assess Ananya outcome effects in this quasi experimental study.

Being tested
Ananya

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • AnanyaBehavioural

    The Ananya program was developed and implemented via a partnership of the Bill and Melinda Gates Foundation and the Government of Bihar as a means of improving reproductive, maternal, newborn and child health (RMNCH) outcomes in the state, in particular focusing on improving health behaviors and service utilization in the final trimester of pregnancy and early postpartum period. Ananya was designed as a series of supply- and demand-side efforts to improve health. Efforts were focused on strengthening outreach services in quantity and quality, improving quality of facility services, and mobilizing communities to improve health behaviors. The Ananya program included training, mobilizing, and monitoring of government frontline health workers (FLWs, including anganwadi workers- AWWS, auxiliary nurse midwives- ANMs, and community health workers-ASHAs) to increase quantity and quality of home visits for RMNH screenings and services, and media messages to increase demand for services.

Study groups in NCT02726230
Study groupRoleWhat they receive
Ananya InterventionExperimental1. Strengthen enumeration and mapping of areas to ensure reach of front line workers (FLWs: auxiliary nurse midwives- ANMs; community health workers- ASHAs; anganwadi workers- AWWs). 2. Convene monthly FLW meetings to build skills and get trained in job kits to increase the quantity and quality of household visits. 3. Train FLWs on communication skills and use of mobile kunji, a job-aid tool, to improve FLWs' communication with households. 4. A mass media campaign inclusive of street theatre, tv and radio, and a mobile van. 5. Community mobilization linking mass media efforts with self-help groups. 6. Quality improvement activities at public health facilities. 7. Facility-based skills training to staff delivering infants to improve quality of care
Receives: Behavioral: Ananya
Control ConditionNo interventionstandard of care public health services in India

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Receipt of two or more home visits from an FLW in the final trimester of pregnancy, using maternal survey response

    Assessed via self-report from representative sample of mothers of children aged 0-11 months; item created for Ananya Survey

    Measured: 2 year follow up

  2. Receipt of any postnatal home visits from an FLW (in the first 24 hours at home after delivery and in first month following delivery), using maternal survey response

    Assessed via self-report from representative sample of mothers of children aged 0-11 months; items created for Ananya Survey

    Measured: 2-year follow-up

  3. Postnatal care behaviors (4 outcomes)- clean cord care, KMC, delayed bath, initiation of breastfeeding), reported by mothers

    Postnatal care practices [Nothing applied to cord or umbilicus; Health worker placed child unclothed on mother's chest/abdomen in skin-to-skin contact; First bath delayed by two or more days; Breastfed child within one hour of birth] assessed via self-report using a single item for each behavior from representative sample of mothers of children aged 0-11 months; items from demographic and health surveys

    Measured: 2 year follow-up

  4. Any complementary feeding of solid or semisolid food for infants aged 6-11 months, using maternal survey response

    a survey item was used to assesse complementary feeding of infants as reported by mothers of infants aged 0-11 months; items taken from the Demographic and Health Survey

    Measured: 2 year follow-up

  5. Immunizations (4 outcomes)- receipt of DBT1 and DBT3 for infants 6-11 mo; receipt of DPT3 and measles vaccine for children 12-23 months, using immunization cards or maternal self report if not card

    data from immunization cards or from self-reports when women did not have cards; approximately 50-60% of participants did not have immunization cards

    Measured: 2 year follow-up

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Apr 2016 (estimated)
  2. Study startJan 2012
  3. Primary completionApr 2014
  4. Study completionApr 2014

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Health services research
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
27,633 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02726230
Sponsor's protocol ID
BMGF#22539
Status last verified
Mar 2016
First submitted
21 Mar 2016
Last updated
1 Apr 2016
Results posted
No
Data monitoring committee
No
Individual data sharing
Yes: Data from this study are public and available from the Bill and Melinda Gates Foundation

Publications

  • Abdalla S, Pair E, Mehta K, Ward V, Mahapatra T, Darmstadt GL. Improving the precision of maternal, newborn, and child health impact through geospatial analysis of the association of contextual and programmatic factors with health trends in Bihar, India. J Glob Health. 2022 Nov 23;12:04064. doi: 10.7189/jogh.12.04064.

    PubMed 36412069
  • Ward V, Abdalla S, Raheel H, Weng Y, Godfrey A, Dutt P, Mitra R, Sastry P, Chamberlain S, Shannon M, Mehta K, Bentley J, Darmstadt Md GL; Ananya Study Group. Implementing health communication tools at scale: mobile audio messaging and paper-based job aids for front-line workers providing community health education to mothers in Bihar, India. BMJ Glob Health. 2021 Jul;6(Suppl 5):e005538. doi: 10.1136/bmjgh-2021-005538.

    PubMed 34312155
  • Darmstadt GL, Weng Y, Pepper KT, Ward VC, Mehta KM, Borkum E, Bentley J, Raheel H, Rangarajan A, Bhattacharya D, Tarigopula UK, Nanda P, Sridharan S, Rotz D, Carmichael SL, Abdalla S, Munar W; Ananya Study Group. Impact of the Ananya program on reproductive, maternal, newborn and child health and nutrition in Bihar, India: early results from a quasi-experimental study. J Glob Health. 2020 Dec;10(2):021002. doi: 10.7189/jogh.10.021002. Epub 2020 Dec 19.

    PubMed 33427822
  • Abdalla S, Weng Y, Mehta KM, Mahapatra T, Srikantiah S, Shah H, Ward VC, Pepper KT, Bentley J, Carmichael SL, Creanga A, Wilhelm J, Tarigopula UK, Nanda P, Bhattacharya D, Atmavilas Y, Darmstadt GL; Ananya Study Group. Trends in reproductive, maternal, newborn and child health and nutrition indicators during five years of piloting and scaling-up of Ananya interventions in Bihar, India. J Glob Health. 2020 Dec;10(2):021003. doi: 10.7189/jogh.10.021003.

    PubMed 33427818
  • Ward VC, Weng Y, Bentley J, Carmichael SL, Mehta KM, Mahmood W, Pepper KT, Abdalla S, Atmavilas Y, Mahapatra T, Srikantiah S, Borkum E, Rangarajan A, Sridharan S, Rotz D, Bhattacharya D, Nanda P, Tarigopula UK, Shah H, Darmstadt GL; Ananya Study Group. Evaluation of a large-scale reproductive, maternal, newborn and child health and nutrition program in Bihar, India, through an equity lens. J Glob Health. 2020 Dec;10(2):021011. doi: 10.7189/jogh.10.021011. Epub 2020 Dec 19.

    PubMed 33425335
  • Ghosh R, Spindler H, Dyer J, Christmas A, Cohen SR, Das A, Sonthalia S, Mahapatra T, Gore A, Shah H, Walker DM. Simulation and team training embedded nurse mentoring programme and improvement in intrapartum and newborn care in a low-resource setting in Bihar, India. J Glob Health. 2020 Dec;10(2):021010. doi: 10.7189/jogh.10.021010. Epub 2020 Dec 19.

    PubMed 33425334
  • Creanga AA, Jiwani S, Das A, Mahapatra T, Sonthalia S, Gore A, Kaul S, Srikantiah S, Galavotti C, Shah H. Using a mobile nurse mentoring and training program to address a health workforce capacity crisis in Bihar, India: Impact on essential intrapartum and newborn care practices. J Glob Health. 2020 Dec;10(2):021009. doi: 10.7189/jogh.10.021009.

    PubMed 33425333
  • Mehta KM, Irani L, Chaudhuri I, Mahapatra T, Schooley J, Srikantiah S, Abdalla S, Ward V, Carmichael SL, Bentley J, Creanga A, Wilhelm J, Tarigopula UK, Bhattacharya D, Atmavilas Y, Nanda P, Weng Y, Pepper KT, Darmstadt GL; Ananya Study Group. Health layering of self-help groups: impacts on reproductive, maternal, newborn and child health and nutrition in Bihar, India. J Glob Health. 2020 Dec;10(2):021007. doi: 10.7189/jogh.10.021007. Epub 2020 Dec 19.

    PubMed 33425331
  • Mehta KM, Irani L, Chaudhuri I, Mahapatra T, Schooley J, Srikantiah S, Abdalla S, Ward VC, Carmichael SL, Bentley J, Creanga A, Wilhelm J, Tarigopula UK, Bhattacharya D, Atmavilas Y, Nanda P, Weng Y, Pepper KT, Darmstadt GL; Ananya Study Group. Health impact of self-help groups scaled-up statewide in Bihar, India. J Glob Health. 2020 Dec;10(2):021006. doi: 10.7189/jogh.10.021006. Epub 2020 Dec 19.

    PubMed 33425330
  • Ward VC, Raheel H, Weng Y, Mehta KM, Dutt P, Mitra R, Sastry P, Godfrey A, Shannon M, Chamberlain S, Kaimal R, Carmichael SL, Bentley J, Abdalla S, Pepper KT, Mahapatra T, Srikantiah S, Borkum E, Rangarajan A, Sridharan S, Rotz D, Nanda P, Tarigopula UK, Atmavilas Y, Bhattacharya D, Darmstadt GL; Ananya Study Group. Impact of mHealth interventions for reproductive, maternal, newborn and child health and nutrition at scale: BBC Media Action and the Ananya program in Bihar, India. J Glob Health. 2020 Dec;10(2):021005. doi: 10.7189/jogh.10.021005. Epub 2020 Dec 19.

    PubMed 33425329
  • Abdalla S, Pair E, Mehta KM, Ward VC, Darmstadt GL. Geospatial variations in trends of reproductive, maternal, newborn and child health and nutrition indicators at block level in Bihar, India, during scale-up of Ananya program interventions. J Glob Health. 2020 Dec;10(2):021004. doi: 10.7189/jogh.10.021004.

    PubMed 33425328

Questions about this trial

What is this clinical trial studying?

A study testing Ananya in people with Maternal and Child Health, run by University of California, San Diego.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 0 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 1 Apr 2016. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Receipt of two or more home visits from an FLW in the final trimester of pregnancy, using maternal survey response (time frame: 2 year follow up). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02726230, which also lists 11 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Apr 2016.

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