TABLE 4.

Risk Ratios for the Association Between Coaching and Health Outcomesa Among BAs During Births in Health Facilities, Utter Pradesh, India

Coaching DomainUnits in Increase

Primary CompositeMaternal Morbidity or Maternal or Infant Mortality(n/N=12,062/79,777)

Secondary CompositeMaternal or Infant Mortality(n/N=3,907/80,234)

Model 1bModel 2cModel 1bModel 2c
RR (95% CI)P ValueRR (95% CI)P ValueRR (95% CI)P ValueRR (95% CI)P Value
Coaching frequency
Visits in past month6.01.03 (0.99, 1.07).141.03 (0.94, 1.13).490.98 (0.92, 1.05).611.01 (0.88, 1.15).91
Mean visits in past month per BA1.31.03 (1.00, 1.06).101.02 (0.97, 1.08).360.98 (0.93, 1.04).540.99 (0.92, 1.07).84
BAs receiving ≥1 visit in past month, %0.71.05 (1.00, 1.10).051.06 (0.98, 1.15).151.00 (0.92, 1.09).991.07 (0.93, 1.22).36
Standard deviation in visits among BAs in past month1.31.02 (0.98, 1.05).300.99 (0.94, 1.05).821.00 (0.95, 1.06).981.06 (0.99, 1.14).11
Cumulative coaching
Total visits8.00.99 (0.97, 1.02).501.02 (0.98, 1.05).421.01 (0.97, 1.05).591.00 (0.94, 1.06).93
Mean visits per BA5.31.01 (0.96, 1.07).701.10 (1.03, 1.18).031.07 (0.98, 1.18).181.10 (0.98, 1.25).16
BAs receiving ≥10 visits, %0.41.00 (0.96, 1.05).871.04 (0.99, 1.09).141.04 (0.96, 1.13).321.04 (0.94, 1.15).42
Standard deviation in visits among BAs3.51.00 (0.95, 1.06).891.04 (0.98, 1.11).251.04 (0.96, 1.13).341.04 (0.96, 1.14).37
Scheduling adherence
Current scheduling nonadherenced11.06 (1.01, 1.12).041.05 (1.00, 1.11).080.97 (0.86, 1.09).580.98 (0.87, 1.10).69
Cumulative scheduling nonadherence121.00 (0.96, 1.05).851.06 (0.99, 1.13)0.101.03 (0.98, 1.09).231.05 (0.99, 1.12).12
  • Abbreviations: BA, birth attendant; CI, confidence interval; RR, risk ratio.

  • a Effects are reported for increasing each continuous coaching metric from its 25th percentile to its 75th percentile, that is, 1 interquartile range. Results are from a generalized linear model with a log link and binomial distribution. Standard errors are estimated using the empirical variance with an exchangeable working covariance structure.

  • b Adjusted for hub name, whether the facility was in a high-priority district, distance to district hospital, facility staff size, facility delivery load, whether birth occurred on the same day as a coaching visit.

  • c Adjusted for everything in Model 1 plus months since start of the intervention.

  • d Because current scheduling nonadherence is a binary outcome, we report the effect for infidelity vs. no infidelity, rather than for a 1 interquartile range increase.