Antenatal corticosteroids are 1 of the most effective hospital-based treatments to reduce neonatal mortality for pregnant women at risk of preterm birth. While studies have shown reductions in neonatal mortality in high- and middle-income countries, and the treatment has been recommended by national and international health organizations, less than 10 of women in low-income countries at risk of preterm birth receive antenatal corticosteroids. This cluster-randomized trial aimed to assess the feasibility, safety, and effectiveness of a multifaceted intervention to increase the use of these treatments in middle- and low- income countries.