Clean Births Are Safe Births: Social Marketing of Clean Birth Kits

A long-entrenched problem in Pakistan is that the poorest women are unable to access functioning health-centres owing to difficulties in physical access, cost constraints, lack of staff and socio-cultural barriers to travelling. In rural areas 75% births take place at home in unhygienic conditions under the supervision of traditional birth attendants. Therefore, neonatal infections are contracted during and immediately after delivery.Clean birth kits (CBKs) are scientifically proven to enable safer home births by preventing life threatening neonatal infections. However, in under-developed areas, CBKs are not available and communities are unaware of their benefits. Our approach is to develop an improved CBK, make it available through local medical stores and create demand in pregnant women and their families through 2 novel strategies- community social marketing and mobile phone-based incentives/lottery.The primary objective is to test the impact of these interventions on increasing use of CBKs and reducing adverse neonatal birth outcomes. By integrating the expertise three diverse organisations - a women's health NGO, a global public health research institute and a leading advertising agency - we expect to increase the usage of CBKs from 5% to 60%. Unlike many other interventions, CBK use has a substantial impact on neonatal birth outcomes but only requires a one-time behaviour change (per birth). The business model ensures full cost recovery; the intervention is self-sustaining during scale up and our sms-data collection-incentive system will allow low cost monitoring of national uptake of CBKs.