Text reminders encourage more women to seek family planning services: Evidence from a randomized control trial in Mozambique

Modern contraception and family planning have substantial health benefits, helping women to manage birth spacing and thus reducing maternal and neonatal mortality and morbidity. However, access is limited in many low- and middle-income countries (LMICs), including in sub-Saharan Africa. In Mozambique, the national unmet need for modern family planning was estimated at 23% in 2015.Among girls aged 15-19, 46% already have one child or are pregnant for the first time; in this group only 14% are using contraception.

In a new study published in BMJ Global Health, we carry out a randomized control trial to analyze the efficacy of using text messaging to encourage women to visit family planning clinics in Mozambique, finding that this “nudge” approach had a modest positive effect. The study, analyzing the behavior of 3,623 women in urban and peri-urban areas in two Mozambique provinces, was conducted in collaboration with Population Services International (PSI), which leads a large community health worker program. Community health workers, known as promoters, offered women information about family planning in home visits, and referred those who requested family planning to local clinics providing free counseling and contraceptive methods.