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) continues to be a major public health challenge in India, with persistent socio-economic and regional inequalities affecting women’s access to essential healthcare services. In recent years, digital health innovations, particularly mobile-based interventions, have shown potential in improving outreach and information delivery to underserved communities. This study assesses the effectiveness of Kilkari, one of the world’s largest mHealth initiatives, which delivers weekly voice messages about reproductive, maternal, newborn, and child health to registered pregnant women. Using pooled data from two rounds of the National Family Health Survey (NFHS-4, 2015–16, and NFHS-5, 2019–21) and a difference-in-differences approach that leverages Kilkari’s staggered rollout across states, we examine how the program affected key health outcomes. The analysis shows that Kilkari significantly improved the likelihood of four or more antenatal care visits, iron–folic acid consumption, and postnatal check-ups, and reduced childhood anaemia. The effects were stronger among poorer and rural households, suggesting that the program successfully reached marginalized populations. However, no significant impact was found on institutional deliveries, tetanus vaccination, or early initiation of breastfeeding, pointing to the need for complementary behavioral and system-level interventions. The validity of these findings is confirmed by robustness checks and placebo tests. This study provides one of the first extensive empirical evaluations of a national mHealth initiative in India, highlighting that well-designed mobile messaging can support better maternal health practices and child outcomes when effectively combined with the existing healthcare system, contributing to India’s progress toward its health goals.