Question

Prompt: Suppose you are a policymaker or researcher conducting a small RCT with the goal of either reducing child or maternal mortality rates (or both). You obtain a grant to test an intervention with a sample of 300 research participants and a budget of approximately $100 per participant. The type of intervention (whether it improves accessibility or infrastructure etc.) is up to you. However, the intervention must be feasible (must apply to the country, must be affordable and practical etc.). 1. Pick a developing country and state the name below. Specify the intervention you want to implement. Why did you pick this intervention for your country? How does it connect to the overall goal? 2. Specify the unit of randomization. For example, is your intervention targeted at the child level, at the mother level, at the village level, at the health center level? 3. Specify the outcome variable(s) you are interested in. How will you measure your outcome(s)?

Answer 1

1) The developing country picked would be Indonesia. Indonesia has a mother moratlity rate of 177 deaths per 100,000 live births, which is significantly higher as compared to developed nations mortality rate.

The intervention implemented is Calcium, Magnesium and Aspirin supplemenation for prevention of Preeclampsia and Eclampsia, which is one of the major complications associated with pregnancies and accounts for around 25% of all deaths during child birth, in addition to around 20% infant deaths. Calcium, Magnesium and Aspirin taken after 20th week of pregnancy till child birth is expected to reduce mother mortality rate as well as child mortality rate by avoiding Preeclampsia and Eclamplea.

2) The unit of randomization chosen is pregnant women. The intervention will be carried out at mother level. The mothers will be randomly given supplements and placebos at health centers. The, after delivery, the complications during delivery, if any, in the placebo group and the supplements group will be compared.

3) The outcome variables targeted are:

1) Number of mother deaths in supplements group and placebo group

2) Number of infant deaths in supplements group and placebo group

3) Number of cases of eclamplsia and preclampsia during delivery in supplement group and placebo group3

The outcome of the trial will be accessed by comparing the values of variables in supplements group and placebo group. All the variables should show significantly reduced values in the supplements group if the trial is a success.