Benefits and challenges of digital enhancements of healthcare worker supervision in Leyte Province, the Philippines
| ISRCTN | ISRCTN86311613 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN86311613 |
| Secondary identifying numbers | SCMC-AEI ERC# 2019-032 |
- Submission date
- 23/12/2021
- Registration date
- 29/12/2021
- Last edited
- 28/04/2022
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Other
Plain English summary of protocol
Background and study aims
Researchers are conducting a research study to investigate and to assist the Leyte Provincial Health Office (PHO) and Department of Health (DOH) in improving the supervision of health workers. The results may help identify opportunities, challenges, priority actions and implications for health worker supervision approaches within the provincial health system. The findings will help the PHO and DOH determine how it could improve the supervision of health workers.
Who can participate?
Supervisors, health care providers, and clients of antenatal care, labor and delivery, postpartum and family planning services
What does the study involve?
As part of this study, the researchers are asking clients about their experience at the health facility on the same day after services are provided. They are asking health workers and supervisors to describe their experiences and satisfaction with SSV and performance management over the past quarter. The inclusion criteria for health workers is based on health areas the research and the supervision system is focused on, namely family planning and basic and emergency obstetrics and maternal and neonatal care services.
What are the possible benefits and risks of participating?
The information provided through the study can help identify opportunities, challenges, priority actions and implications for health worker supervision approaches within the provincial health system. The findings will help the PHO and DOH determine how it could improve the supervision of health workers. There are not any expected risks for this study.
Where is the study run from?
APMARGIN with the Leyte Provincial Health Office and takes place in primary health care facilities across the Leyte IHLZs (Philippines)
When is the study starting and how long is it expected to run for?
September 2019 to June 2021
Who is funding the study?
United States Agency for International Development (USAID) through the Human Resources for Health in 2030 (HRH2030) Program, Cooperative Agreement No. AID-OAA-A-15-00046.
Who is the main contact?
1. Dr Eckhard Kleinau, ekleinau@urc-chs.com
2. Rachel Deussom, MSc, rdeussom@chemonics.com
Contact information
Principal Investigator
1275 New Jersey Avenue SE
Washington DC
20003
United States of America
 ORCID ID |
0000-0002-6784-9637 |
|---|---|
| Phone | +1 6172336201 |
| rdeussom@hrh2030program.org |
Scientific
5404 Wisconsin Avenue, Suite 800
Chevy Chase, MD
20815
United States of America
| Phone | +1 (301) 654-8338 |
|---|---|
| ekleinau@urc-chs.com |
Public
1275 New Jersey Avenue SE
Washington
20003
United States of America
| Phone | +1 6172336201 |
|---|---|
| rdeussom@hrh2030program.org |
Study information
| Study design | Mixed-methods parallel arm group-randomized design |
|---|---|
| Primary study design | Interventional |
| Secondary study design | Randomised parallel trial |
| Study setting(s) | GP practice |
| Study type | Other |
| Participant information sheet | 40858_PIS_V1.2_18Dec19.pdf |
| Scientific title | Enhancing supervision: Philippines implementation study |
| Study objectives | Innovative digital enhancements of health care worker supervision in Leyte Province contribute to improved health worker competence, more efficient, strategic performance management, increased data use and client satisfaction. |
| Ethics approval(s) | Approved 01/22/2020, St. Cabrini Medical Center - Asian Eye Institute (SCMC-AEI) Ethics Review Committee (2nd Floor, Old Building, Maharlika Highway, Santo Tomas, 4232 Batangas, Philippines; +63 (0)43 778 4811; scmc-aeierc@asianeyeinstitute.com), ref: SCMC-AEI ERC# 2019-032 |
| Health condition(s) or problem(s) studied | Assessment and action plans for improving the quality and standards of care of basic emergency obstetric and newborn care (BEmONC) and family planning at the primary care level |
| Intervention | 15-month, two-arm experiment with one pre-intervention assessment (baseline) and two post-intervention assessments at 6-month intervals (midline and endline). Randomization of the 9 IHLZs was completed by the research team with the Leyte PHO on 06/11/2019 using https://www.dcode.fr/random-selection. At this time, the PHO agreed to have four Inter-Local Health Zones (ILHZs) in the treatment group and five in the control group. The intervention was a combination of three interrelated digital enhancements to the health worker supportive supervision system: 1) digitized supervision checklists using ODK on Android tablets used by supervisors, 2) a digital dashboard of checklist data used by ILHZ supervisors and health system managers at quarterly supportive supervision visits (SSV), and 3) digitized self-assessment checklists using ODK on Android tablets used by health workers in between quarterly SSVs. The control group maintained their planned supportive supervision visits (SSV) per the Leyte Provincial Health Office’s (PHO) quarterly schedule. Supervisors used the standard, paper-based SSV checklists and did not have the control group’s SSV results available on any digital dashboard. The health care providers in the control group were not requested to (nor did they perform) any self-assessments. |
| Intervention type | Behavioural |
| Primary outcome measure | Health worker competency, supervisor performance, data use, health systems effects, and client satisfaction were measured through Likert scale survey questions at baseline, midline (6 months) and endline (12 months) and review of health system service delivery indicators in FHSIS (the health management information system) |
| Secondary outcome measures | Health worker competency was measured using quarterly SSV checklists for 12 months |
| Overall study start date | 30/09/2019 |
| Completion date | 01/06/2021 |
Eligibility
| Participant type(s) | Mixed |
|---|---|
| Age group | Adult |
| Lower age limit | 18 Years |
| Sex | Both |
| Target number of participants | 183 supervisors, 456 providers, 684 clients. |
| Key inclusion criteria | 1. Clients of BEmONC and FP services at primary health care facilities in Leyte Province (over 15 years old) 2. Health care providers of BEmONC and FP services at primary health care facilities in Leyte Province (over 18 years old) 3. ILHZ supervisors of BEmONC and FP services at primary health care facilities in Leyte Province (over 18 years old) |
| Key exclusion criteria | Clients under 15 years of age |
| Date of first enrolment | 24/01/2020 |
| Date of final enrolment | 30/04/2021 |
Locations
Countries of recruitment
- Philippines
Study participating centre
McArthur Highway
Poblacion, Guiguinto, Bulacan
3015
Philippines
Sponsor information
Other
1275 New Jersey Avenue SE
Washington
20003
United States of America
| Phone | +1 6172336201 |
|---|---|
| rdeussom@chemonics.com | |
| Website | https://chemonics.com/ |
Funders
Funder type
Government
Government organisation / National government
- Alternative name(s)
- U.S. Agency for International Development, Agency for International Development, USAID
- Location
- United States of America
Results and Publications
| Intention to publish date | 30/04/2022 |
|---|---|
| Individual participant data (IPD) Intention to share | Yes |
| IPD sharing plan summary | Stored in publicly available repository |
| Publication and dissemination plan | Planned publication in a high-impact peer-reviewed journal. |
| IPD sharing plan | The cleaned, fully anonymized datasets generated during and/or analysed during the current study will be stored in a publically available repository: the USAID Development Experience Clearinghouse (DEC) https://dec.usaid.gov/dec/home/Default.aspx |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Participant information sheet | version 1.2 | 18/12/2019 | 29/12/2021 | No | Yes |
| Protocol file | version 3.2 | 04/02/2021 | 29/12/2021 | No | No |
Additional files
Editorial Notes
28/04/2022: Internal review.
25/04/2022: A contact email was updated.
29/12/2021: Trial's existence confirmed by the St. Cabrini Medical Center - Asian Eye Institute (SCMC-AEI) Ethics Review Committee.
