Can a Decision-Making Nudge Improve Birth Outcomes?

Margaret McConnell and Jessica Cohen of Harvard School of Public Health in the U.S. will evaluate whether motivating pregnant women to choose a health care facility for delivering their baby prior to the onset of labor, along with offering free transportation to that facility, increases the safety of childbirth in Kenya. Currently, maternal and neonatal deaths in developing countries remain high despite the availability of high quality facilities for child delivery. Obstacles to using these facilities include lack of transportation and limited information on their quality, which means many couples avoid deciding and end up either giving birth at home or going to a suboptimal facility, sometimes after a long delay. They will conduct a pilot study by recruiting 1,200 pregnant women in Nairobi, and evaluate whether offering transportation vouchers to a pre-chosen facility positively impacts delivery outcomes and timing of arrival at health care facilities.