Applying behavioral science to increase use of maternal care services: Findings from a field experiment in northern Nigeria

Many pregnant women do not seek or receive maternal health care, endangering their health and that of their unborn babies. This problem is especially acute in low- and lower-middle-income nations, where rates of maternal mortality and morbidity are high. Incentives and digitally delivered communication can encourage women to use maternal services, thereby improving maternal health outcomes. However, behavioral evidence to support the most effective combination of components for these interventions is limited. We tested the impact of a nondigital incentivized intervention against a digital nonincentivized behavior change communication intervention (interactive voice messaging) on the uptake of antenatal services and the use of a skilled birth attendant (a midwife, nurse, or doctor who is trained to deliver babies) in parts of Nigeria, a lower-middle-income country. We randomized 845 participants to receive one of the two interventions or no intervention. We found that the nondigital incentivized intervention increased the probability that women would use antenatal care and a skilled birth attendant significantly more than the digital messaging.