Working Paper: NBER ID: w26044
Authors: Omar Galarraga; Jeffrey E. Harris
Abstract: Several countries have implemented “family-centered” abstinence-only policies for teenagers, as opposed to encouraging utilization and expansion of reproductive health services and education. Little is known, however, about the effects of these more restrictive policies on adolescent birth rates at the national level or their differential effects by race and ethnicity. The extant literature is even scarcer in low- and middle-income countries. We analyze an unexpected policy change in Ecuador that abruptly reversed course and restricted reproductive health services for teenage women in 2014. We use a canton- and time-fixed effects difference-in-differences analysis of Ecuador’s 221 cantons with time-varying controls to analyze the impact of the abrupt policy change on the difference of teen (15-19 years) minus young adult (20-24 years) birth rates. In a difference-in-difference-in-differences analysis, the policy change increases birth rates by 8.5 births per 1000 women in cantons with higher indigenous concentration. Results are robust to changes in the comparison population (young adults vs. women in their late 20s or in their early 30s), pre-intervention control periods, population weighting, serial correlation, logarithmic model specification, adjustments for intervention year, definition of indigenous concentration, and potential delays in policy implementation.
Keywords: adolescent birth rates; Ecuador; sexual and reproductive health policy; difference-in-differences; indigenous populations
JEL Codes: I12; I18; J13; J18
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| sudden policy change in SRH policy in Ecuador (J18) | increase in adolescent birth rates (J13) |
| sudden policy change in SRH policy in Ecuador (J18) | increase in adolescent birth rates in cantons with higher indigenous concentrations (J13) |
| increase in adolescent birth rates (J13) | increase in birth rates among teens compared to young adults (J13) |