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Cited by 22Global Maternal and Child HealthChild Nutrition and Water AccessMaternal and Neonatal Healthcare

Proactive community case management and child survival: protocol for a cluster randomised controlled trial

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Whidden, Caroline, Treleaven, Emily, Liu, Jenny, Padian, Nancy, Poudiougou, Belco, Bautista-Arredondo, Sergio, Fay, Michael P, Samaké, Salif +5 more·2019·BMJ Open
DOI 10.1136/bmjopen-2018-027487PMC PMC6720240
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Abstract

Introduction: Community health workers (CHWs)—shown to improve access to care and reduce maternal, newborn, and child morbidity and mortality—are re-emerging as a key strategy to achieve health-related Sustainable Development Goals (SDGs). However, recent evaluations of national programmes for CHW-led integrated community case management (iCCM) of common childhood illnesses have not found benefits on access to care and child mortality. Developing innovative ways to maximise the potential benefits of iCCM is critical to achieving the SDGs. Methods and analysis: An unblinded, cluster randomised controlled trial in rural Mali aims to test the efficacy of the addition of door-to-door proactive case detection by CHWs compared with a conventional approach to iCCM service delivery in reducing under-five mortality. In the intervention arm, 69 village clusters will have CHWs who conduct daily proactive case-finding home visits and deliver doorstep counsel, care, referral and follow-up. In the control arm, 68 village clusters will have CHWs who provide the same services exclusively out of a fixed community health site. A baseline population census will be conducted of all people living in the study area. All women of reproductive age will be enrolled in the study and surveyed at baseline, 12, 24 and 36 months. The survey includes a life table tracking all live births and deaths occurring prior to enrolment through the 36 months of follow-up in order to measure the primary endpoint: under-five mortality, measured as deaths among children under 5 years of age per 1000 person-years at risk of mortality. Ethics and dissemination: The trial has received ethical approval from the Ethics Committee of the Faculty of Medicine, Pharmacy and Dentistry, University of Bamako. The results will be disseminated through peer-reviewed publications, national and international conferences and workshops, and media outlets. Trial registration number: NCT02694055; Pre-results.

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Authors
Whidden, C., Treleaven, E., Liu, J., Padian, N., Poudiougou, B., Bautista-Arredondo, S., Fay, M. P., Samaké, S., Cissé, A. B., Diakité, D., Keita, Y., Johnson, A. D., & Kayentao, K.
Affiliations
  • University of Michigan (US)
  • University of California, San Francisco (US)
  • University of California, Berkeley (US)
  • Instituto Nacional de Salud Pública (MX)
  • National Institute of Allergy and Infectious Diseases (US)
  • Ministère de la Santé et de l'Hygiène Publique (ML)
  • Université des Sciences, des Techniques et des Technologies de Bamako (ML)
Corresponding author
Whidden, Caroline
ORCID
Venue
BMJ Open
Publisher
BMJ
Published
2019-08
Volume
9
Issue
8
Pages
e027487
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2018-027487
PMC
PMC6720240
OpenAlex
W2970136671
Cited by
22
References
3
Citations by year
2026: 1 · 2025: 1 · 2024: 5 · 2023: 3 · 2022: 5 · 2021: 7
FWCI
3.12
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • BMJ Open (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (acceptedVersion)
  • HighWire Press Open Archive (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion, cc-by-nc)
Funders
  • Johnson and Johnson
  • Child Relief International Foundation
  • Muso
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
Keywords
community health workers, integrated community case management, under-five mortality, child survival, home visits, childhood diseases, rural Mali, health care access, Sustainable Development Goals
MeSH terms
Child, Child Health Services, Child, Preschool, Community Health Workers, Female, Follow-Up Studies, House Calls, Humans, Infant, Mali, Rural Population, Multicenter Studies as Topic, Randomized Controlled Trials as Topic, Case Management, Child Mortality, Pragmatic Clinical Trials as Topic

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