Using incentives to increase participation in prenatal care

Area of Science:

• Public Health
• Maternal Health
• Health Services Research

Background:

• Prenatal and postpartum care are crucial for maternal and infant health.
• Low-income women face significant barriers to accessing consistent healthcare.
• Incentives are sometimes used to improve healthcare engagement.

Purpose of the Study:

• To evaluate the effectiveness of two incentive types in increasing prenatal and postpartum care participation among low-income women.
• To determine if incentives can overcome common barriers to care access.

Main Methods:

• A randomized controlled trial involving 205 Medicaid-eligible women.
• Intervention groups received gift certificates or gift certificates plus a raffle entry for prenatal appointments.
• Outcomes measured included appointment attendance, satisfaction, gestation length, and birth weight.

Main Results:

• No significant differences in appointment attendance or other outcomes were observed between incentive groups and the control group.
• High rates of missed appointments persisted, with 39% missing prenatal and 45% missing postpartum appointments.
• Commonly cited reasons for missed appointments included lack of transportation, inclement weather, and illness.

Conclusions:

• Financial incentives and raffle chances are ineffective in overcoming barriers to prenatal care for low-income women.
• Addressing practical barriers such as transportation is essential for improving access to maternal healthcare.