eRegMat – a digital registry for improved quality of antenatal care: a cluster-randomized trial in a rural area in Bangladesh

Venkateswaran, Mahima; Pervin, Jesmin; Dolphyne, Akuba; Friberg, Ingrid K.; Fjeldheim, Ingvild; Frøen, J. Frederik; Khatun, Fatema; O’Donnell, Brian; Rahman, Monjur; Rahman, A. M. Quaiyum; Nu, U Tin; Rose, Christopher James; Sarker, Bidhan Krishna; Rahman, Anisur

doi:10.1186/s44247-023-00059-4

Table 1 Definitions of trial outcomes, the corresponding intervention sub-component and the trial period when all sub-components were available

From: eRegMat – a digital registry for improved quality of antenatal care: a cluster-randomized trial in a rural area in Bangladesh

Outcome	Definition	Intervention with direct effect	Implementation period with all sub-components available
Timely attendance at eligible ANC visits	Timely ANC attendance at recommended visits^a	Targeted Client Communication via SMS: ANC appointment reminders Health worker clinical decision support Feedback dashboard with action items	December 2019 – June 2020
Screening and management of hypertension in pregnancy	Screening with blood pressure measurement at recommended ANC visits^a and blood pressure within normal range; and appropriate management if hypertension is detected at any time^b	Health worker clinical decision support Feedback dashboard with action items	October 2018 – June 2020
Timely first antenatal care visit	ANC visit at or before 16 weeks^c	Targeted client communication via SMS: ANC visit appointment reminder for first ANC visit	July 2019 – June 2020
High risk^d women successfully referred to a skilled provider for additional care	Additional care received among those referred for severe anemia, hypertension, or diabetes during pregnancy	Health worker clinical decision support Targeted client communication via SMS: Referral reminders, high risk, facility delivery reminders	July 2019 – June 2020
Facility delivery	Health facility delivery among those that should deliver in a health facility according to identified risk factors during pregnancy	Health worker clinical decision support Targeted client communication via SMS: facility delivery reminders	July 2019 – June 2020
Perinatal mortality and severe perinatal morbidities among all and among those with any risk factors identified^d	Mortality and morbidities in the perinatal period^e among all enrolled participants and among those with a risk factor identified in the woman during pregnancy	Health worker clinical decision support Feedback dashboard with action items Targeted client communication via SMS: ANC appointment reminders, referral reminders, facility delivery reminders	December 2019 – June 2020
Severe postpartum anemia	Severe anemia in the postpartum period (hemoglobin 7 g/dl)	Health worker clinical decision support Feedback dashboard with action items Targeted client communication via SMS: ANC appointment reminders, Referral reminders, high risk, facility delivery reminders	December 2019 – June 2020

ANC Antenatal care
^aRecommended antenatal care visits and gestational age windows for analysis: 16 weeks (≤ 17 + ⁶ weeks), 24 + ⁰ to 28 + ⁶ weeks, 32 weeks (31 + ⁰ to 33 + ⁶ weeks), and 36 weeks (35 + ⁰ to 37 + ⁶ weeks)
^bDefined as systolic blood pressure ≥ 140 mm Hg and diastolic blood pressure ≥ 90 mm Hg at ≥ 20 weeks of gestation, chronic hypertension if detected < 20 weeks
^cDefined as an ANC visit ≤ 17 + ⁶ weeks
^dRisk pregnancies were generated automatically in the eRegistry based on the documentation of certain conditions according to the national guidelines in Bangladesh
^eDefined as having a stillbirth, early neonatal death, very preterm birth, very low birthweight baby, a neonate that was severely ill or hospitalized in the first week of life

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ISSN: 2731-684X

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