Rotheram‐Borus 2017.

Study name	To evaluate if increased supervision and support of South African government health workers’ home visits improves maternal and child outcomes
Methods	Study design: cluster‐RCT Country: South Africa
Participants	Pregnant women Inclusion criteria:  a. living in the catchment area; b. not identified as psychotic or delusional based on the interviewer’s judgement. Exclusion criteria: a. inability to give informed consent; b. inability to converse with the interviewer or the CHW; c. death of the mother or infant. Stated purpose: to examine whether the benefits of ongoing accountability and supervision within an existing government funded and implemented community health workers (CHW) home visiting programme ensure the effectiveness of home visiting
Interventions	Intervention: Accountable Care Condition (AC) In the Accountable Care Condition, additional monitoring and accountability systems that Philani routinely uses are implemented. All CHWs will receive a mobile phone and initial Philani training for conducting home visits. The CHWs’ implementation will be consistently monitored and an accountability system will be established. CHWs in the AC will log their home visits on their mobile phones, including a rating of the content and skills addressed on the visit, children’s height and weight, and report on achievement of outcomes such as receiving the child grant, immunizations, breastfeeding, and retention and adherence to HIV care. Supervision will facilitate CHW skill improvement over time. In addition to gathering real‐time data on the health of the household, the mobile phone monitoring system automatically lists all follow‐up visits needed for each week. Control: Usual care (Standard Care Condition of initial Philani training, but with supervision and monitoring being delivered by local government structures and systems. The CHW will visit the mothers twice monthly during pregnancy until children are 6 months and then monthly until the children reach 2 years of age. After the first 6 months, the CHW focuses on encouraging mothers to stimulate and support their children daily. Households in the target areas will be visited by government‐funded CHWs. The existing government‐implemented training, monitoring, and supervision structures will remain in place with the only addition being an initial Philani training for conducting home visits)
Outcomes	Participants'outcomes of interest for this review Diagnosis of mental disorders (depression prevalence) – Edinburgh Perinatal Depression Inventory (EPDS), classification based on scores above the cut‐off, EPDS > 13 Mental health symptoms/depression – Edinburgh Perinatal Depression Inventory (EPDS) Economic outcomes Nil Time points: baseline, post‐intervention (3 months, 6 months, 15 months and 24 months postpartum)
Starting date	1 June 2017
Contact information	Mary Jane Rotheram‐Borus, mrotheram@mednet.ucla.edu
Notes	Source of funding: National Institute of Mental Health (NIMH; R01MH111391), the Center for HIV Identification, Prevention and Treatment Services (CHIPTS; P30MH058107), the UCLA Center for AIDS Research (CFAR; P30AI028697), the National Center for Advancing Translational Sciences through UCLA Clinical and Translational Science Institute (CTSI; UL1TR001881), and the Postdoctoral HIV Research Training Program for HIV Combination Prevention (T32; T32MH109205) Prospective trial registration number: NCT02957799