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General

Study Overview

Title:

Demand Creation for Voluntary Medical Male Circumcision in Tanzania: an Impact Evaluation (Bwana Mkubwa)

Study is 3ie funded:

Yes

Study ID:

RIDIE-STUDY-ID-54610bbb892eb

Initial Registration Date:

11/10/2014

Last Update Date:

11/09/2014

Study Status:

In Development

Location(s):

Tanzania

Abstract:

A mixed methods quasi experimental study to evaluate an approach to increase uptake of voluntary medical male circumcision services by men aged 20 and above at fixed service delivery sites in Iringa, Njombe and Tabora regions of Tanzania.

Registration Citation:

Mahler, H. and Bazant, E., 2014. Demand Creation for Voluntary Medical Male Circumcision in Tanzania: an Impact Evaluation (Bwana Mkubwa). Registry for International Development for Impact Evaluations (RIDIE). Available at: 10.23846/ridie040

Categories:

Health, Nutrition, and Population

Additional Keywords:

Bwana Mkubwa Study

Secondary ID Number(s):

GBT/PL/JC/VOL.I/244/07- Gaming Board of Tanzania

Principal Investigator(s)

Name of First PI:

Hally Mahler

Affiliation:

Jhpiego an affiliate of JHU

Name of Second PI:

Eva Bazant

Affiliation:

Jhiego, an affiliate of JHU

Study Sponsor

Study Sponsor Location:

United States

Research Partner

Name of Partner Institution:

Ministry of Health and Social Welfare- Tanzania

Type of Organization:

Government agency (eg., statistics office, Ministry of Health)

Location:

Tanzania

Intervention

Intervention Overview

Intervention:

The proposed intervention to increase adult male attendance at VMMC involves a weekly raffle of Smartphones for VMMC clients and a separate Smartphone raffle for the peer promoters and providers for the duration of three months involving seven intervention facilities. VMMC clients enrolled in the study and returning within seven days for a follow up visit will be eligible for a Smartphone raffle. Peer promoters and providers get a single ticket for raffle for every five successful referrals. The raffle will follow Tanzania Gaming Board regulations. Objectives: (1)To assess whether a motivational incentive (entry into a Smartphone raffle) can achieve a net 20% increase (25% at intervention and 5% at comparison sites) in the number of VMMC clients aged 20 + at routine service delivery sites; (2)To assess whether a motivational incentive can increase the number of successful referrals to VMMC fixed sites made by peer promoters and health providers;(3)To understand and document the types of motivation that men have for seeking VMMC services in comparison sites, and in intervention sites;4)To compare the costs of providing VMMC services at intervention and comparison sites.

Theory of Change:

Multiple Treatment Arms Evaluated?

Yes

Implementing Agency

Name of Organization:

Jhpiego, an affiliate of Johns Hopkins University, in collaboration with Ministry of Health and Social Welfare of Tanzania

Type of Organization:

NGO (International)

Program Funder

Name of Organization:

International Initiative for Impact Evaluation (3ie)

Type of Organization:

Other

Intervention Timing

Intervention or Program Started at time of Registration?

No

Start Date:

10/27/2014

End Date:

01/27/2015

Evaluation Method

Evaluation Method Overview

Primary (or First) Evaluation Method:

Randomized control trial

Other (not Listed) Method:

Additional Evaluation Method (If Any):

Other (not Listed) Method:

Method Details

Details of Evaluation Approach:

The evaluation will be conducted in 14 paired health facilities. There will be random assignment in each pair to intervention or comparison. Intervention sites will offer smart phone raffle. No matching or randomization for individuals. Based on the routine data from the Voluntary Medical Male Circumcision (VMMC) sites, approx. 600 men aged 20 + will receive VMMC services in intervention sites and approx. 600 men in comparison sites in the duration of 3 months. In the intervention sites these are eligible to participate in a weekly raffle. Intervention: Routine individual data for approx.600 VMMC clients aged 20+ A subset of these (approx. 256) will be randomly (from a list of raffle participants) selected to complete supplemental client form. 21 Peer Promoters (PP) for Focus Group Discussion (FGD),21 Health Care Providers (HCP) for provider interview. All PPs and HCPs referring clients to VMMC services will be eligible for a monthly raffle. Comparison: Routine individual data for approx. 600 VMMC clients aged 20+. 21 PP for FGD 21 HCP for provider interview. A PP is any person whose work is to raise awareness, inform, sensitize and promote VMMC in his/her community.

Outcomes (Endpoints):

1) Percentage increase in the number of VMMC clients aged 20 and above at routine service delivery sites during three months of intervention 2) Proportional increase of the number of successful referrals (referred and received VMMC) to VMMC made by peer promoters and health providers during the intervention period 3)Documented types of motivation that men have for seeking VMMC services in comparison sites and intervention sites 4) Documented costs of providing VMMC services at intervention and comparison sites

Unit of Analysis:

VMMC clients aged 20 and above at VMMC service delivery sites

Hypotheses:

1)An intervention using Smartphones will increase adult male attendence at VMMC by up to 20%. 2)An intervention using Smartphones will increase the number of successful referrals.

Unit of Intervention or Assignment:

The unit of assignment is a health facility. No assignment to study arm at the individual level

Number of Clusters in Sample:

Seven pairs of facilities have been selected that were purposefully matched based on location, patient volume and type of facility. One in each matched pair will be randomly assigned to intervention

Number of Individuals in Sample:

A maximum of 714 clients from intervention and comparison facilities will be involved

Size of Treatment, Control, or Comparison Subsamples:

Treatment: 600 VMMC clients; 42 peer promoters FGD; 21 providers. Comparison: 30 VMMC clients FGD and 21 Providers

Supplementary Files

Analysis Plan:

Data

Outcomes Data

Description:

Analysis for primary outcome: Attendance at VMMC service is recorded routinely and entered in a de-identified routine program client-level database.

Data Already Collected?

No

Data Previously Used?

Data Access:

Data Obtained by the Study Researchers?

Data Approval Process:

Approval Status:

Treatment Assignment Data

Participation or Assignment Information:

Yes

Description:

Data Obtained by the Study Researchers?

Data Previously Used?

Data Access:

Data Obtained by the Study Researchers?

Data Approval Process:

Approval Status:

Data Analysis

Data Analysis Status:

Study Materials

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Registration Category

Registration Category:

Prospective, Category 1: Data for measuring impacts have not been collected

Completion

Completion Overview

Intervention Completion Date:

Data Collection Completion Date:

Unit of Analysis:

Clusters in Final Sample:

Total Observations in Final Sample:

Size of Treatment, Control, or Comparison Subsamples:

Findings

Preliminary Report:

Preliminary Report URL:

Summary of Findings:

Paper:

Paper Summary:

Paper Citation:

Data Availability

Data Availability (Primary Data):

Date of Data Availability:

Data URL or Contact:

Access procedure:

Other Materials

Survey:

Survey Instrument Links or Contact:

Program Files:

Program Files Links or Contact:

External Link:

External Link Description:

Description of Changes:

Study Stopped

Date:

Reason: