International Institute for Population Sciences
Deemed to be University (An Autonomous Organization of Ministry of Health & Family Welfare, Government of India)

Maternal and child health (MCH) remains a key public health priority in India, where persistent socio-economic and geographic inequalities continue to limit access to essential care despite significant progress in recent decades. Digital health innovations, particularly mobile-based interventions, have emerged as promising tools to bridge these gaps. This study evaluates the impact of Kilkari, one of the world’s largest mobile health programs, which delivers weekly voice messages on reproductive, maternal, newborn, and child health to registered women. Using pooled data from two rounds of the National Family Health Survey (NFHS-4, 2015–16, and NFHS-5, 2019–21) and employing a difference-in-differences approach that leverages Kilkari’s staggered rollout across states, the study estimates the program’s effect on key maternal and child health outcomes. The results show that Kilkari significantly increased the likelihood of four or more antenatal care visits, iron–folic acid consumption, and postnatal check-ups, while reducing the prevalence of childhood anaemia. The impacts were stronger among poorer and rural households, highlighting the program’s potential to reach disadvantaged populations. However, no significant effects were observed on institutional deliveries, tetanus vaccination, or immediate breastfeeding, indicating the need for complementary behavioral and systemic interventions. Robustness checks and placebo tests confirm the validity of these findings. The study provides one of the first large-scale empirical evaluations of a national mHealth initiative in India, demonstrating that mobile-based information delivery can improve maternal health behaviors and child outcomes when effectively integrated with existing healthcare systems, contributing to progress toward the Sustainable Development Goals.