The Impact of Non-monetary Incentives on Facility Delivery in Rural Zambia

Measuring the Impact of Non-monetary Incentives on Facility Delivery in Rural Zambia: A Clustered Randomized Controlled Trial

This study measured the impact and cost-effectiveness of a low-cost, non-monetary incentive ("mama kit") on rural facility delivery rates in Zambia.

This clustered randomized controlled trial assessed the impact of providing a package of childcare items (a cloth, baby diaper, and blanket) to women conditional upon delivering at a facility on facility delivery rates in rural Serenje and Chadiza Districts in Zambia. Facilities were randomized to either provide the intervention or not. Facility-level antenatal care (ANC) and delivery registers were used to measure the percentage of women attending antenatal care who delivered at a study facility during the intervention period. Results from the trial were then used to model the cost-effectiveness of mama kits at-scale in terms of cost per death averted.

Inclusion Criteria:

• Had an antenatal care record at one of the study facilities
• Had an estimated date of delivery (as measured by estimated date of last menstrual period, estimated date of delivery, or estimated gestational age in weeks as recorded in the antenatal care register) between June 1, 2013 - Aug 31, 2013.

Exclusion Criteria:

• Did not have an antenatal care record at one of the study facilities
• Had an estimated date of delivery outside of the intervention window (June 1, 2013 - Aug 31, 2013)