Impact assessment and cost-effectiveness of m-health application used by community health workers for maternal, newborn and child health care services in rural Uttar Pradesh, India: a study protocol
Open accessAbstract
BACKGROUND: An m-health application has been developed and implemented with community health workers to improve their counseling in a rural area of India. The ultimate aim was to generate demand and improve utilization of key maternal, neonatal, and child health services. The present study aims to assess the impact and cost-effectiveness of this project. METHODS/DESIGN: A pre-post quasi-experimental design with a control group will be used to undertake difference in differences analysis for assessing the impact of intervention. The Annual Health Survey (2011) will provide pre-intervention data, and a household survey will be carried out to provide post-intervention data.Two community development blocks where the intervention was introduced will be treated as intervention blocks while two controls blocks are selected after matching with intervention blocks on three indicators: average number of antenatal care checkups, percentage of women receiving three or more antenatal checkups, and percentage of institutional deliveries. Two categories of beneficiaries will be interviewed in both areas: women with a child between 29 days and 6 months and women with a child between 12 and 23 months. Propensity score matched samples from intervention and control areas in pre-post periods will be analyzed using the difference in differences method to estimate the impact of intervention in utilization of key services.Bottom-up costing methods will be used to assess the cost of implementing intervention. A decision model will estimate long-term effects of improved health services utilization on mortality, morbidity, and disability. Cost-effectiveness will be assessed in terms of incremental cost per disability-adjusted life year averted and cost per unit increase in composite service coverage in intervention versus control groups. CONCLUSIONS: The study will generate significant evidence on impact of the m-health intervention for maternal, neonatal, and child services and on the cost of scaling up m-health technology for accredited social health activists in India.
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The pre-intervention AHS 2011 and post-intervention CEAHH 2015 surveys were conducted with comparable methods, tools and data collection techniques.
“Both the CEAHH and AHS surveys used similar methods, tools and data collection techniques [16,19].”
Propensity score matching was used to reduce selection bias and control demand-side characteristics that could affect MNCH service utilisation, because intervention blocks were not randomly chosen.
“Since the choice of the two intervention blocks was not random, it could have resulted in selection bias.To minimise this, the propensity score method (PSM) was used to control for the demand-side characteristics among women in intervention and control group which could influence utilisation of various MNCH services [19].”
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- Authors
- Prinja, S., Nimesh, R., Gupta, A., Bahuguna, P., Thakur, J. S., Gupta, M., & Singh, T.
- Affiliations
- Post Graduate Institute of Medical Education and Research (IN)
- Corresponding author
- Prinja, Shankar
- ORCID
- Venue
- Global Health Action
- Publisher
- Informa UK Limited
- Published
- 2016-05-13
- Volume
- 9
- Issue
- 1
- Pages
- 31473-31473
- ISSN
- 1654-9716 (ISSN-L)
- 1654-9880
- PMC
- PMC4870358
- OpenAlex
- W2368910609
- Cited by
- 24
- References
- 29
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 2 · 2022: 3 · 2021: 3 · 2019: 4 · 2018: 6 · 2017: 2
- FWCI
- 4.65
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Global Health Action (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Physical Sciences › Computer Science › Information Systems › ICT in Developing Communities
- Keywords
- mobile health, community health workers, Accredited Social Health Activists, obstetric care, newborn health services, child health services, prenatal care, institutional delivery, health care utilization, health care demand, cost-effectiveness, disability-adjusted life years, rural Uttar Pradesh
- MeSH terms
- Child Health Services, Community Health Workers, Cost-Benefit Analysis, Counseling, Developing Countries, Female, Humans, India, Infant, Infant, Newborn, Maternal Health Services, Pregnancy, Prenatal Care, Models, Statistical, Telemedicine, Rural Health Services, Quality-Adjusted Life Years, Propensity Score, Mobile Applications
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