Warranty on Womanhood

Organization: 
Avigo Health LLC
Organization Location: 
Washington, D.C., USA

Current applications of financial incentives for demand-generation in maternal care, such as conditional cash transfers, have improved uptake of antenatal care, but have shown inconsistent effects on facility delivery and are often complex to administer at scale. Avigo Health proposes to offer an explicit, unconditional service guarantee – the Warranty on Womanhood, or “WoW” – to pregnant women in Nasarawa State, Nigeria, who opt for birth in a health facility. If a client is dissatisfied with the care she gets, she may invoke WoW and choose up to the maximum offered as a good-faith payment for her ordeal. This proposal’s hypothesis is that low uptake of facility delivery is often due to poor expectations of care in health facilities. By refocusing on quality as defined by the customer, WoW targets pregnant women who are agnostic or antagonistic to facility birth.  Avigo Health will use a mixed-methods design to document WoW’s effect on client and provider experience as well as roll-out challenges. They will also assess early effects on facility delivery rates.

WoW is a novel application of a long-used marketing device to health, and holds the promise to alter the basis of competition in maternal care: by signaling their intent to meet client expectations, and aligning operations to deliver good service, health facilities can use guarantees to ward off less competent competition, capture market share, and build enduring customer loyalty. If Avigo Health shows proof of concept, they expect gradual adoption by public and private providers of maternal care until a critical mass of consumers expect breakthrough service and providers see a clear linkage between quality and client patronage.