Improving Uptake of Antenatal Care Services in Rural Côte d'Ivoire
Taabo ANC
Supply and Demand-Side Interventions to Improve Uptake of Antenatal Care Services: a Randomized Controlled Trial in Rural Côte d'Ivoire
1 other identifier
interventional
1,290
1 country
1
Brief Summary
The past two decades have brought significant increases in the availability of maternal health care services in many low- and middle-income countries, with a large increase in the number of health facilities that provide these services. However, many women still do not receive the basic services recommended by the World Health Organization. In many settings, antenatal care is associated with substantial financial cost, which means that obtaining high quality care can involve complex intrahousehold bargaining and decision-making. Women have more access to information about these services, but men generally make the financial decisions. If men are unaware of the magnitude and timing of financial needs, securing adequate financial resources may be difficult. The investigators plan to conduct a randomized-controlled experiment of supply- and demand-side solutions to increase uptake of recommended antenatal care services in rural Côte d'Ivoire, where there are currently substantial gaps in service coverage. Despite Côte d'Ivoire's "free maternity care" policy, many recommended services - including ultrasounds and laboratory tests - continue to carry costs for patients. On the supply side, the study will evaluate the impact of providing key services (including ultrasounds, laboratory testing, and iron and folic acid supplements) for free to pregnant women (in line with Côte d'Ivoire's policy of free provision). On the demand side, the study will evaluate the impact of providing information about antenatal care recommendations to pregnant women (alone or with their partners), and of providing a financial planning session to pregnant women or their partners, or both together. The study will evaluate the impacts of these interventions on the uptake of recommended antenatal care services.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Jan 2026
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
December 19, 2025
CompletedFirst Posted
Study publicly available on registry
January 14, 2026
CompletedStudy Start
First participant enrolled
January 16, 2026
CompletedPrimary Completion
Last participant's last visit for primary outcome
February 1, 2027
ExpectedStudy Completion
Last participant's last visit for all outcomes
February 1, 2027
January 22, 2026
January 1, 2026
1 year
December 19, 2025
January 19, 2026
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
Proportion of women receiving recommended antenatal care services
The primary endpoint is the proportion of women receiving the following recommended antenatal care services during their pregnancy, as measured through recall during endline surveys with pregnant women: * At least four antenatal care visits with a skilled provider AND * At least one ultrasound AND * At least one laboratory assessment.
During pregnancy (measured 4-8 weeks after the end of pregnancy)
Secondary Outcomes (8)
Proportion of participants receiving the recommended number of malaria chemoprophylaxis doses during pregnancy
During pregnancy (measured 4-8 weeks after the end of pregnancy)
Proportion of participants receiving high-quality antenatal care measured using antenatal care booklets
During pregnancy (measured 4-8 weeks after the end of pregnancy)
Average antenatal care knowledge scores among pregnant women and their partners
Measured 4-8 weeks after the end of pregnancy
Proportion of women who delayed or missed care for financial reasons
Measured 4-8 weeks after the end of pregnancy
Proportion of women who are satisfied with the antenatal care health services that they received
Measured 4-8 weeks after the end of pregnancy
- +3 more secondary outcomes
Study Arms (6)
1a) Information video only
EXPERIMENTALParticipants in this arm will be shown a short video that describes key recommendations for antenatal care and health during pregnancy, based on national guidelines in Côte d'Ivoire.
1b) Information video + Vouchers
EXPERIMENTALParticipants in this arm will be shown a short video that describes key recommendations for antenatal care and health during pregnancy, based on national guidelines in Côte d'Ivoire. They will also receive vouchers to cover the costs of a set of key antenatal health care services.
2a) Information video + financial planning
EXPERIMENTALParticipants in this arm will be shown a short video that describes key recommendations for antenatal care and health during pregnancy, based on national guidelines in Côte d'Ivoire. They will also receive a financial planning session facilitated by a member of the study team.
2b) Information video + financial planning + vouchers
EXPERIMENTALParticipants in this arm will be shown a short video that describes key recommendations for antenatal care and health during pregnancy, based on national guidelines in Côte d'Ivoire. They will also receive a financial planning session facilitated by a member of the study team. Finally, they will also receive vouchers to cover the costs of a set of key antenatal health care services.
3a) Information video + financial planning with partners
EXPERIMENTALParticipants in this arm will be shown a short video that describes key recommendations for antenatal care and health during pregnancy, based on national guidelines in Côte d'Ivoire. They will view it a first time alone, and a second time with their partners. They will also receive a financial planning session facilitated by a member of the study team, together with their partners.
3b) Information video + financial planning with partners + vouchers
EXPERIMENTALParticipants in this arm will be shown a short video that describes key recommendations for antenatal care and health during pregnancy, based on national guidelines in Côte d'Ivoire. They will view it a first time alone, and a second time with their partners. They will also receive a financial planning session facilitated by a member of the study team, together with their partners. Finally, they will also receive vouchers to cover the costs of a set of key antenatal health care services.
Interventions
Participants will be shown a short video that describes key recommendations for antenatal care and health during pregnancy, based on national guidelines in Côte d'Ivoire. In arms (1a-1b) and (2a-2b), this video will be shown only to the pregnant woman. In arms (3a-3b), this video will be shown to the pregnant woman together with her partner.
In this intervention, a member of the study team will facilitate a structured discussion about planning for the expenses of health care services and related transportation costs over the course of pregnancy. The discussion will follow a series of questions and prompts set up as a survey form in ODK (attached to this protocol). The study team member will also share a list of the local prices of recommended antenatal care services. In arms (2a-2b), this intervention is delivered only to pregnant women. In arms (3a-3b), this intervention is delivered to pregnant women together with their partners.
This intervention consists of vouchers for a pre-defined set of antenatal care services. Pregnant women who are randomized to receive this intervention will be given vouchers for one ultrasound, one "bilan prenatal" (a recommended set of prenatal laboratory tests in Côte d'Ivoire), and a 6-month supply of iron \& folic acid supplements (with dosage based on their health care provider's recommendation). The study team will establish agreements with local health facilities to provide services in exchange for these vouchers, with reimbursement by the study team.
Eligibility Criteria
You may qualify if:
- Currently pregnant
- Aged 15 years or older
- Live in the area served by the Taabo Health \& Demographic Surveillance System
- Estimated gestational age of less than 6 completed months of pregnancy
- Aged 15 and older
- Married to or currently the main romantic partner of a woman who is enrolled in the study
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (1)
Centre Suisse de Recherches Scientifiques en Cote d'Ivoire
Taabo, Côte d’Ivoire
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- SINGLE
- Who Masked
- INVESTIGATOR
- Purpose
- OTHER
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
December 19, 2025
First Posted
January 14, 2026
Study Start
January 16, 2026
Primary Completion (Estimated)
February 1, 2027
Study Completion (Estimated)
February 1, 2027
Last Updated
January 22, 2026
Record last verified: 2026-01
Data Sharing
- IPD Sharing
- Will share
- Shared Documents
- STUDY PROTOCOL, SAP, ICF, ANALYTIC CODE
- Time Frame
- We plan to share IPD and supporting information at the time of publication.
- Access Criteria
- IPD and supporting information will be made available on public repositories.
De-identified data files and analytic code will be posted on public repositories at the time of publication of results.