Table 3 Data collected for testing specific research questions
Hypotheses/research questions | Data collection methods | Sampling methods | Informants/ data sources | Dates/locations |
|---|---|---|---|---|
The CBIO+ Approach improves the population coverage of interventions that are designed to address the epidemiological priorities for mothers and children relative to a Comparison Area (Area B) and compared to (1) baseline levels, (2) selected nearby municipalities of the Department of Huehuetenango where the Project was not working (using data obtained in MSPAS documents), and (3) the rural population of the Department of Huehuetenango (using data from the national Demographic and Health Survey). Findings presented in Paper 3 [3]. | Baseline KPC survey | 30-cluster stratified cluster sampling | 300 mothers of under-2 children in each Area | January 2012/ both Areas A and B |
Endline Project KPC survey | 30-cluster stratified cluster sampling | 300 mothers of under-2 children in each Area | June 2015/ both Areas A and B | |
The CBIO+ Approach improves the nutritional status of children relative to a Comparison Area (Area B) and relative to (1) baseline levels, (2) selected nearby municipalities of the Department of Huehuetenango where the Project was not working (using data obtained in MSPAS documents), and (3) the rural population of the Department of Huehuetenango (using data from the national Demographic and Health Survey). Findings are presented in Paper 4 [4] | Baseline KPC survey | 30-cluster stratified cluster sampling | 300 under-2 children weighed in both Areas A and B | January 2012/ both Areas A and B (weight but not height measured) |
Anthropometric household survey | 30-cluster stratified cluster sampling | 288 under-2 children weighed and measured | September 2012/ Area A only | |
Anthropometric “censuses” | No sampling since all children had their weight and height measured (by visiting all homes) | All under-2 children weighed and measured (ranged from 871 to 1,203 children in each “census”) | June 2013, Sept 2013, and January 2014 (Area A only) Aug 2014 and Nov 2014 (both Areas A and B) | |
Endline KPC survey | 30-cluster stratified cluster sampling | 300 under-2 children weighed and measured for each Area | June 2015/ Both Areas A and B | |
The CBIO+ Approach reduces under-5 and maternal mortality relative to a Comparison Area (Area B) and compared to (1) baseline levels, (2) selected municipalities of the Department of Huehuetenango where the Project was not working, and (3) the rural population of the Department of Huehuetenango. Findings presented in Paper 5 [5]. | Gathering of all vital events in Project Area | Analysis of Register data for all births, stillbirths, and maternal/U-5 deaths | Vital events gathered by Comunicadoras, Level-1 Promoters, and Level-2 Promoters | Oct 2011 to May 2015 (Area A) Oct 2013 to May 2015 (Areas A and B) |
Verbal autopsies | Analysis of verbal autopsies for all maternal and U-5 deaths | Families of 34 deceased women and 314 under-5 children | ||
MSPAS mortality data for the Department of Huehuetenango | Analysis of MSPAS maternal and under-5 mortality data for the Project’s 3 municipalities and for 3 comparison municipalities outside of the Project Area | Government national vital events registry (Registro Civil) | July 2015 (3 comparison municipalities outside the Project Area) | |
The staff of the Birthing Centers successfully managed many perinatal complications and in the process contributed to the reduction in maternal and perinatal mortality in the Project communities over the course of the Project. The success of the Birthing Center staff in managing complications can be attributed to intensive training and an extensive support network The management of complications is often compromised by delays in reaching the Birthing Center or by not accepting referral from the Birthing Center staff when recommended Findings are presented in Paper 6 [6] | Review of clinical records | Clinical records of deliveries with complications | Register created of complications recorded in clinical records | July–Aug 2016 |
Self-directed written questionnaire | Purposive sample of staff | Birthing Center staff: Supervisory Nurses, Auxiliary Nurses, and support women | Nov 2016 | |
FGDs | Dec 2016 | |||
Key-informant interviews | Purposive sample of staff | Project Director | Dec 2016 | |
The CBIO+ Approach produces significant increases in women’s participation in community health activities relative to the Comparison Area. The CBIO+ Approach produces significant increases in women’s health-related decision-making autonomy relative to the Comparison Area | Baseline KPC survey | 30-cluster stratified cluster sampling | 300 mothers of under-2 children for each survey | Jan 2012 (both Areas A and B) |
Endline KPC survey | 30-cluster stratified cluster sampling | 300 mothers of under-2 children for each survey | June 2015 (both Areas A and B) | |
FGDs | Purposive sampling | Women, men/husbands, mothers-in-law, and Community Health Committees | Jan 2014 (Area A) | |
Key informant interviews | Purposive sampling | Community Level-1 Promoters, | May 2015 (both Areas A and B) | |
FGDs | Comunicadoras, and Self-Help Group participants | |||
The CBIO+ Approach produces significant increases in community involvement in problem solving relative to a Comparison Area Findings are presented in Paper 8 [8] | Baseline KPC survey | 30-cluster stratified cluster sampling | 300 mothers of under-2 children for each survey | Jan 2012 (both Areas A and B) |
Endline KPC survey | 30-cluster stratified cluster sampling | 300 mothers of under-2 children for each survey | June 2015 (both Areas A and B) | |
FGDs | Purposive sampling | Women, husbands/partners, mothers-in-law, and Community Health Committee members | Jan 2014 | |
What are the lessons learned in implementing the CBIO+ Approach? How can the CBIO+ Approach be best and most feasibly introduced into the MSPAS framework for health care delivery? Findings presented in Paper 9 [9]. | Written questionnaire Key-informant interviews FGDs Group interviews Key-informant Interviews | Purposive sampling | Curamericas/Guatemala staff and MSPAS staff Curamericas/Guatemala staff and MSPAS staff Level-1 Promoters Existing literature about PEC | July 2013 (Area A) Aug 2013 (Area A) June 2015 May 2015 Aug-Nov 2015 |
How does the cost-effectiveness of the CBIO+ Approach as implemented by Curamericas Global in Guatemala compare to that of other Guatemala maternal and child health programs using different methodologies (based on cost-per-life saved and cost-per- DALY averted)? What are the prospects for scaling up CBIO+ in Guatemala and for implementing and testing it in other countries? Findings presented in Paper 10 [10] | Literature review Cost analysis; LiST (Lives Saved Tool) | Not applicable Not applicable Not applicable | Analysis of Project fiscal records, Project Vital Events Registers, and registers of community census data | Nov 2015 (both Areas A and B) |