Study setting and participants
The study took place in the deeply rural King Sabata Dalindyebo Health Subdistrict of the OR Tambo District, Eastern Cape of South Africa [Prior to randomization, we documented the size of the clinics’ catchment areas, density of housing in the catchment area, the number of women initiating antenatal care at the clinic over the previous year, and the topography of the clinic catchment area (including the average slope). Due to substantial variations between some of the clinics’ catchment areas and size of their catchment populations, UCLA paired 2 sets of 4 clinics each to help create catchment areas that were largely similar for each pair and then used a random number generator to randomly assign one set of the matched pairs to either the Accountable Care (AC) or to the Standard Care (SC) conditions.