Digital Self-Efficacy to Support Preference-Aligned Fertility Management: A randomized evaluation among married adolescent girls in Kaduna State, Nigeria

Last registered on May 11, 2026

Pre-Trial

General Information

Title

RCT ID

AEARCTR-0018397

Initial registration date

May 07, 2026

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published

May 11, 2026, 9:14 AM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Locations

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Primary Investigator

Name

Celine Wuyts

Affiliation

Innovations for Poverty Action

Contact Primary Investigator

Other Primary Investigator(s)

Additional Trial Information

Status

In development

Start date

2026-05-11

End date

2027-06-30

Keywords

Gender, Health, Other

Additional Keywords

Sexual and reproductive health, Contraception, Digital

JEL code(s)

Secondary IDs

Prior work

This trial does not extend or rely on any prior RCTs.

Abstract

Adolescent pregnancy rates in northern Nigeria are among the highest in the country, driven in large part by early marriage and very low contraceptive use. Married adolescent girls face compounding barriers to reproductive health services, including limited digital access, a gap that constrains their ability to obtain information and ongoing support aligned with their own preferences. There is growing evidence that digital technologies can help bridge these gaps, but rigorous evidence on whether digital health interventions improve reproductive health outcomes for is lacking. This cluster-randomized controlled trial evaluates whether layering digital components onto an existing in-person sexual and reproductive health program improves preference-aligned fertility management and contraceptive self-efficacy among married adolescent girls aged 15–19 in Kaduna State, Nigeria.

The study enrolls approximately 1,890 participants across 126 primary health care centers randomized in a 1:1:1 ratio to three arms: a control arm receiving the standard MMA program only; a second arm receiving MMA plus digital access and a mobile technical literacy curriculum; and a third arm receiving MMA plus digital access, mobile literacy, and a digital SRH intervention. Primary outcomes are preference-aligned fertility management and contraceptive self-efficacy. Quantitative surveys will be conducted at baseline, midline (6 months), and endline (12 months). Findings will provide evidence on whether and how digital access, digital literacy, and digital self-efficacy shape adolescent reproductive health outcomes.

External Link(s)

Registration Citation

Citation

Wuyts, Celine. 2026. "Digital Self-Efficacy to Support Preference-Aligned Fertility Management: A randomized evaluation among married adolescent girls in Kaduna State, Nigeria." AEA RCT Registry. May 11. https://doi.org/10.1257/rct.18397-1.0

Sponsors & Partners

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Experimental Details

Interventions

Intervention(s)

All participants receive the standard MMA program, which includes mobilization by female community mentors, client-led counseling, access to contraceptive services, and four Life, Family, and Health skills sessions covering SRH knowledge and soft and vocational skills.

Study arm 2 adds provision of a mobile device for program use, and a mobile technical literacy curriculum covering phone navigation, internet access, mobile security, and settings. Study arm 3 adds a layered digital SRH intervention component that improves access to quality reproductive health information.

Intervention Start Date

2026-07-01

Intervention End Date

2026-10-31

Primary Outcomes

Primary Outcomes (end points)

Preference-aligned fertility management (Holt et al. 2023)
Contraceptive self-efficacy (Whiting-Collins et al. 2020)

Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)

Secondary Outcomes (explanation)

Experimental Design

Health care centers serve as the unit of randomization. Primary health care centers (PHCs) implementing the MMA program in Kaduna State are randomly selected from the MMA program list after removing wards with known security concerns, stratified by Local Government Area, then randomized 1:1:1 to the three study arms. Within each PHC, approximately 15 participants are randomly sampled from lists of newly mobilized eligible girls, for a total sample of 1,890 participants across 126 clusters.

Experimental Design Details

Not available

Randomization Method

Computer-based randomization conducted by PI

Randomization Unit

Primary health care center

Was the treatment clustered?

Yes

Experiment Characteristics

Sample size: planned number of clusters

126 (3 x 42) primary health centers

Sample size: planned number of observations

1,890 (3 x 630) married adolescent girls

Sample size (or number of clusters) by treatment arms

Study arm 1 (Control): 630 participants in 42 PHCs
Study arm 2: 630 participants in 42 PHCs
Study arm 3: 630 participants in 42 PHCs

Minimum detectable effect size for main outcomes (accounting for sample design and clustering)

Calculations assume 80% power, two-sided significance level of 5%, cluster-level ICC of 0.05, 15 participants per cluster, and 5% anticipated attrition. For preference-aligned fertility management (PFM), the study can detect a minimum absolute difference of 10 percentage points between arms, assuming a control group prevalence of 60%. For contraceptive self-efficacy (CSE), the study can detect a minimum difference of 0.21 standard deviations between arms, equivalent to a 0.54-point difference on the 11-point CSE scale (assuming SD = 2.55).

Supporting Documents and Materials

IRB

Institutional Review Boards (IRBs)

IRB Name

Innovations for Poverty Action IRB

IRB Approval Date

2026-04-16

IRB Approval Number

4983

Analysis Plan