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Objective 3: CLIP Trials Updates (February 2017 - January 2017)

The CLIP Trial has recruited a total of 77,169 pregnancies to date, and all three trials have ended the active phase of recruitment.

It is with extreme excitement that we announce that the CLIP Mozambique Trial has ended the active phase of recruitment of the trial. All three trials are now in the final stage of data querying and preliminary analyses have commenced in India.

The CLIP Mozambique Trial ended active recruitment on 24 February 2017 with a total of 18,620 women, and 31,105 POM guided antenatal and postnatal visits, with 72% being antenatal visits. The team is now focussed on outcome adjudication, responding to data queries, data cleaning and the continuation of community engagement for CLIP women who were still pregnant at the end of the trial as required by their local ethics board. More than 3,900 community engagement sessions have taken place with over 16,000 participants.

Four more neighborhoods in Mozambique have now joined the community transport plan, bringing the total to thirteen. The transport scheme has evolved into a general community fund, as it is being used for any community members who require transport to a hospital. Twelve people have benefited, nine of which were pregnant or postpartum women.

A plan for undertaking economic analysis in Mozambique is underway presently. The site investigators are preparing to submit the health economics protocol for institutional ethics approval.

A site visit was conducted by Sumedha Sharma and Larry Li in February to discuss study closeout activities, monitor study progress and discuss analysis plans. We would like to extend our thanks to the CISM team for their hospitality and for organising all the logistics related to this visit.

In India, the data collection for maternal and newborn health services costs has been completed in sixty private health facilities in Belagavi and Bagalkot. A cost allocation exercise has also been undertaken at six public health facilities. Furthermore, the field team has ascertained costs related to the ASHA/ANM program (such as salaries, transport and training support) during CLIP trial implementation. A review of data for consistency is in-progress.    

In Pakistan, the manuscript “Societal perspective on cost drivers for technology assessment in Sindh Pakistan” has been accepted for publication in the International Journal of Health Technology Assessment in Health Care [forthcoming 2017]. Data analysis is underway to estimate the cost of implementing CLIP Trial in Pakistan.

Economic evaluations are great decision-making tools for stakeholders and policy makers. Even if they cannot implement the whole program, they can choose the components they can afford and implement those.

India and Pakistan country teams are also continuing their efforts to complete outcome adjudication of reported outcomes.