Community Health Educators and Maternal Health: Evidence from a Randomized Controlled Trial

Though Nigeria is home to 2% of the world's population, it accounts for more than 10% of the world's maternal deaths. This paper reports on the results of a cluster randomized controlled trial evaluating three interventions targeted at increasing utilization of maternal health services and decreasing maternal and neonatal mortality in northern Nigeria: the deployment of voluntary community health educators, denoted Community Resource Persons or CORPs, to encourage pregnant women to utilize health facilities for delivery; the CORPs program in conjunction with the provision of safe birth kits; and the CORPs program in conjunction with community media activities. A sample of 7,000 women in 96 communities was tracked over four years. The results indicate that the interventions had a significant impact on increasing antenatal and postnatal care utilization, but did not increase the probability of a facility-based delivery, and did not significantly affect maternal or neonatal health outcomes. Further exploration suggests that this may reflect both weak coverage of the intervention and a low quality of care at health facilities.