Clinical Trial: Bihar Evaluation of Social Franchising and Telemedicine

Study Status: Completed
Recruit Status: Completed
Study Type: Observational

Official Title: Bihar Evaluation of Social Franchising and Telemedicine in India

Brief Summary: This study will conduct an evaluation of the World Health Partners (WHP) private provider project to see if the social franchising and telemedicine project has an impact on health outcomes in treatment vs. control areas. The evaluation will also estimate specific parameters of the WHP program that can be used to maximize financial sustainability and replicability/scalability of the program.

Detailed Summary:

In 2011, World Health Partners (WHP) will launch a large social franchising program of healthcare delivery in Bihar, India, with funding from the Bill and Melinda Gates Foundation (BMGF). The WHP project is particularly innovative in integrating a social franchising delivery model with a telemedicine platform. Although social franchising models of delivery are becoming increasingly common, to our knowledge, none of these efforts has been rigorously evaluated.

COHESIVE-India plans to undertake an evaluation of the BMGF-financed WHP project. The overarching focus of the evaluation project (called Bihar Evaluation of Social Franchising and Telemedicine (BEST)) is to provide evidence on the performance and effectiveness of the WHP program. In addition to studying the overall impact and effectiveness of the social franchising and telemedicine program, the evaluation will estimate how the WHP model influences outcomes related to two target diseases of interest to BMGF: childhood diarrhea and childhood pneumonia.

The Evaluation Design The core objective of the evaluation is to estimate the causal impact of the WHP program on BMGF target disease outcomes as well as other indicators of its primary health care success. The key design feature of the evaluation is that it relies on the franchisee network model of the WHP program. The evaluation design involves identifying villages in Bihar that have asymmetric digital subscriber line (ADSL) connectivity where WHP is likely to find providers who would participate in the program. The areas surrounding these villages that form catchment areas for providers will be identified; 360 such areas will be randomly sampled from the list and divided into 180 treatment and 180 control areas for implementation of the WHP program.

The study also incl
Sponsor: Duke University

Current Primary Outcome: Improvements in population based health outcomes [ Time Frame: Baseline; 3 years ]

Improvements in population based health outcomes in the treatment vs. the control areas


Original Primary Outcome: Improvements in population based health outcomes [ Time Frame: Baseline; 2 years; 4 years ]

Improvements in population based health outcomes in the treatment vs. the control areas


Current Secondary Outcome:

  • Improvements in population based health outcomes for childhood diarrhea [ Time Frame: Baseline; 3 years ]
    Proportion of children with diarrhea in the last two weeks who were treated with zinc
  • Improvements in population based health outcomes for childhood pneumonia [ Time Frame: Baseline; 3 years ]
    Proportion of children with suspected pneumonia in the past two weeks who received a full course of antibiotics (five days)
  • Cost-effectiveness of the service model [ Time Frame: Baseline; 3 years ]
    Through micro-experiments, we hope to gain insights on how to improve the cost effectiveness of the WHP model, as well as evaluate its financial sustainability. We will also evaluate whether the are overall improvements in the population level health indicators in the treatment vs. the control areas.


Original Secondary Outcome:

  • Improvements in population based health outcomes for childhood diarrhea [ Time Frame: Baseline; 2 years; 4 years ]
    Proportion of children with diarrhea in the last two weeks who were treated with zinc
  • Improvements in population based health outcomes for childhood pneumonia [ Time Frame: Baseline; 2 years; 4 years ]
    Proportion of children with suspected pneumonia in the past two weeks who received a full course of antibiotics (five days)
  • Improvements in health outcomes for tuberculosis [ Time Frame: Baseline; 2 years; 4 years ]
    Median number of days from symptom onset to treatment
  • Improvements in health outcomes for visceral leishmaniasis (VL) [ Time Frame: Baseline; 2 years; 4 years ]
    Proportion of individuals that completed appropriate treatment for VL
  • Effectiveness of the service model [ Time Frame: Baseline; 2 years; 4 years ]
    Through micro-experiments, we hope to gain insights on how to improve the effectiveness of the WHP model, as well as its financial sustainability.


Information By: Duke University

Dates:
Date Received: April 25, 2011
Date Started: May 2011
Date Completion:
Last Updated: December 14, 2015
Last Verified: December 2015