JMIR Publications

ABSTRACT

Background:

Despite increasing options for public and private health care providers in Lao PDR, choosing a high-quality health provider or a facility is difficult because timely and reliable information about providers is not readily available. Additionally, only 28% describe their recent visit to a health care provider as high-quality suggesting that while there are increasing options for care, people may need support to find providers that meet their quality needs. In order to inform efforts to improve people's access to high-quality care, there is a need for evidence on mechanisms to empower people to identify and use high-quality care. Rapid adoption of mobile phones in Lao PDR, particularly in urban areas, offer opportunities to enhance people's access to timely quality information about health care facilities.

Objective:

The primary outcome will be the proportion of mothers that changed their preferred health care facility for non-urgent child health care services between the baseline and endline surveys. Secondary outcomes will include changes in preferred providers for urgent health care services, satisfaction with recent health care visits, the number and types of health care providers used in the past 3 months, the use of digital information services to inform health facility choices, and confidence in ability to identify the best paediatric care providers. Binary outcomes will be analysed using logistic regression models, and continuous outcomes will be analysed using linear regression models.

Methods:

An unblinded randomized controlled trial (RCT) design will be performed. Mothers with at least one child under 2 years old and already enrolled in the Vientiane Multigenerational Birth Cohort (VITERBI) will be invited to participate in the study during in-person visits by the research staff. The control and intervention groups will have an equal number of randomly assigned participants. The intervention group will receive a URL to the consisting of facility ratings for pediatric health care services every two weeks via a WhatsApp message; the control group will not receive anything. We will also use WhatsApp to administer bi-weekly surveys among both groups to assess quality of health care received in the past 2 weeks. The webpage shared with the intervention group via WhatsApp will display the results from these surveys and the pilot study. Research staff will conduct baseline and endline surveys that are three months apart to all participants during in-person visits.

Results:

The trial is currently in progress. The anticipated completion date for the study is October, 2024.

Conclusions:

This study will use a demand-side intervention to enhance demand for high-quality care for children among mothers in Vientiane capital. We will measure whether information about quality of health care facilities – generated by study participants throughout the study period – influences mothers to change their preferred health care providers for non-urgent conditions. Clinical Trial: ClinicalTrials.gov: NCT06304831; https://www.clinicaltrials.gov/study/NCT06304831