Risk Ratios for the Association Between Coaching and Health Outcomesa Among BAs During Births in Health Facilities, Utter Pradesh, India
| Coaching Domain | Units 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 1b | Model 2c | Model 1b | Model 2c | ||||||
| RR (95% CI) | P Value | RR (95% CI) | P Value | RR (95% CI) | P Value | RR (95% CI) | P Value | ||
| Coaching frequency | |||||||||
| Visits in past month | 6.0 | 1.03 (0.99, 1.07) | .14 | 1.03 (0.94, 1.13) | .49 | 0.98 (0.92, 1.05) | .61 | 1.01 (0.88, 1.15) | .91 |
| Mean visits in past month per BA | 1.3 | 1.03 (1.00, 1.06) | .10 | 1.02 (0.97, 1.08) | .36 | 0.98 (0.93, 1.04) | .54 | 0.99 (0.92, 1.07) | .84 |
| BAs receiving ≥1 visit in past month, % | 0.7 | 1.05 (1.00, 1.10) | .05 | 1.06 (0.98, 1.15) | .15 | 1.00 (0.92, 1.09) | .99 | 1.07 (0.93, 1.22) | .36 |
| Standard deviation in visits among BAs in past month | 1.3 | 1.02 (0.98, 1.05) | .30 | 0.99 (0.94, 1.05) | .82 | 1.00 (0.95, 1.06) | .98 | 1.06 (0.99, 1.14) | .11 |
| Cumulative coaching | |||||||||
| Total visits | 8.0 | 0.99 (0.97, 1.02) | .50 | 1.02 (0.98, 1.05) | .42 | 1.01 (0.97, 1.05) | .59 | 1.00 (0.94, 1.06) | .93 |
| Mean visits per BA | 5.3 | 1.01 (0.96, 1.07) | .70 | 1.10 (1.03, 1.18) | .03 | 1.07 (0.98, 1.18) | .18 | 1.10 (0.98, 1.25) | .16 |
| BAs receiving ≥10 visits, % | 0.4 | 1.00 (0.96, 1.05) | .87 | 1.04 (0.99, 1.09) | .14 | 1.04 (0.96, 1.13) | .32 | 1.04 (0.94, 1.15) | .42 |
| Standard deviation in visits among BAs | 3.5 | 1.00 (0.95, 1.06) | .89 | 1.04 (0.98, 1.11) | .25 | 1.04 (0.96, 1.13) | .34 | 1.04 (0.96, 1.14) | .37 |
| Scheduling adherence | |||||||||
| Current scheduling nonadherenced | 1 | 1.06 (1.01, 1.12) | .04 | 1.05 (1.00, 1.11) | .08 | 0.97 (0.86, 1.09) | .58 | 0.98 (0.87, 1.10) | .69 |
| Cumulative scheduling nonadherence | 12 | 1.00 (0.96, 1.05) | .85 | 1.06 (0.99, 1.13) | 0.10 | 1.03 (0.98, 1.09) | .23 | 1.05 (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.