‘Combined Interventional Approach vs. Conventional Utilization of Full Antenatal Care Services and Pregnancy Outcome in District Dehradun: A Cluster Randomized Controlled Trial’ a Study Protocol.

Abstract

Introduction: MMR of Uttarakhand state is very high as comparison to national index and it is on 27th position in India out of 35 states and union territories to provide full ANC services. In Dehradun district, full ANC of urban and rural are quite low 15.3% and 23.2% respectively, even in urban region half than the national index 31.1%. Aim: To determine the effect of Combined Interventional Approach (CIA) to achieve full ANC among pregnant women and its impact on pregnancy outcome. Material and methods:-A cluster randomized controlled trial will be conducted in Dehradun district, Uttarakhand among all pregnant women registered in first trimester, will be selected by multi stage cluster sampling. Sample size will be calculated after pilot study. A precise inclusion and exclusion criteria will be followed. Study duration will be 10 months 15 days. Combined Interventional Approach (CIA): It includes multiple interventions (control room, mobile application, community participation, identification and utilization of alternative referral transport at community level and sensitization of community for high risk pregnancy) with conventional/routine ANC services. Tools: Subject data sheet, Mother and Child Protection Card, Reproductive and Child Health Register and Delivery register. Statistical analysis: Data will be collected and analyzed using descriptive and inferential statistics (p < 0.5). Discussion: This study, if proven effective, then without any extra cost and burden, ANC services can be strengthened with these interventions and full ANC coverage can be improved which ultimately improve pregnancy outcome as well as maternal and neonatal health that is a big need of time, especially in low resource countries like India.