ARC Study Overview
The ARC study is a composite of three studies designed to improve maternal health care in Kenya. International Centre for Reproductive Health Kenya (ICRHK) is collaborating with Jhpiego to implement the three studies.
Having a birth companion (BC) is a simple and low-cost intervention that can improve both maternal and newborn health outcomes and maternal experiences. The BC study strives to evaluate the impact of a birth companion (BC) intervention package on the penetration/coverage of BCs during labor, birth, and the postnatal period. The study also seeks to determine the acceptability, feasibility, and impact on coverage of facility births attended by a companion introduced at 24 health facilities in Machakos (12) and Murang’a (12) Counties. The study population will include all women who deliver at participating facilities plus their companions (if present in intervention facilities), all providers anticipated to rotate through the unit during the study period, plus unit managers.
Networks of Care (NoC)
New approaches are needed to establish more efficient and effective systems for providing quality, people-centered care at each point of care within the public and private sectors, and to ensure coordinated, continuous care along the continuum of care. The primary objective is to assess the effect of establishing a Network of Care (NoC) on relationships among health facilities in Makueni County. The secondary objective is to assess the acceptability and feasibility of a NoC within the existing county and sub-county health care and referral systems. The NoC Framework proposes four interconnected inputs towards building a successful NoC: 1) Agreement and Enabling Environment, 2) Operational Standards, 3) Quality, Efficiency, and Responsibility, and 4) Learning and Adaptation. Using an implementation research (IR) approach, the study will continuously test network elements that foster collaboration and communication between and within participating health facilities, generating evidence about what works, what is feasible, and what is acceptable9
Group Antenatal Care (G-ANC)
Research on Group ANC (G-ANC) in low and middle-income countries (LMICs) has reported an association with increased antenatal care (ANC) attendance, improved provision of quality care, and greater satisfaction for women when compared to individual ANC. This study will measure the feasibility, acceptability, effectiveness, fidelity, and sustainability of scaling up G-ANC within ANC services to the extent possible within each facility’s context; and in facilities that adopt G-ANC as the predominant service delivery model (i.e., where G-ANC becomes the default standard of routine care [instead of individual care] the feasibility, acceptability, fidelity, effectiveness, and sustainability. This is a mixed-methods implementation research study with process evaluation of the G-ANC scale-up and continuously providing evidence of its success to implementers. The study is taking place within 12 health facilities in Machakos County.