Empowering Women to Save for their Preferred Delivery

Policy Context

In rural Zambia, pregnant women often fail to deliver at a health facility contributing to high levels of maternal and neonatal mortality, and poor postpartum health (Sacks et al., 2016). Pregnant women face significant financial barriers to accessing safe delivery services due to costs associated with birth supplies and transportation to their preferred facility (Scott et al., 2018). Despite the removal of user fees by the government, the total cost of the materials a pregnant woman is expected to bring to a facility remains a significant outlay for the average rural household (US$40, approximately 25% of average monthly household expenditure). In most cases, personal savings must be built up during pregnancy to afford these costs, though women in Zambia often struggle to save adequately for delivery, reducing their likelihood of delivering at a facility and the quality of care they receive (Chiu et al., 2019).

Study Design

Chiu (Health Economics, UC Berkeley) and colleagues developed a set of interventions to increase savings among pregnant women specifically to help them access safe delivery services. Together with international NGO, World Vision Zambia, they piloted maternity grants to pregnant women in savings groups and, separately, a behavioral tool that helps women set goals and develop a personalized savings plan. The pilot confirmed the feasibility of the approach and demonstrated strong initial uptake.
This new, follow-on project tests the necessary data collection instruments and field protocols, and generates a complete a listing of savings groups in the study area in preparation for a full randomized evaluation to understand whether the interventions are effective and why.

Results and Policy Lessons

Results forthcoming.