Working Paper: NBER ID: w27271
Authors: Grant Miller; Ureo De Paula; Christine Valente
Abstract: Nearly one-quarter of married, fertile-age women in Sub-Saharan Africa say that they want to avoid pregnancy but are not using contraceptives. To the best of our knowledge, this paper is the first to study this puzzle in a developing country using detailed data on women’s subjective probabilistic beliefs about contraception and contraceptive attributes. Policy counterfactuals based on a structural model suggest that costly interventions such as eliminating supply constraints would only have modest effects on contraceptive use. Alternatively, increasing partners’ approval of methods, aligning partners’ fertility preferences with women’s, and correcting women’s expectations about pregnancy risk absent contraception have the potential to increase use considerably. We provide additional empirical support for this last result through a before/after experiment in which we find that simply (and effectively) informing women about underlying pregnancy risk increases stated intentions to use contraception substantially, in line with our initial estimates.
Keywords: Contraception; Subjective Expectations; Family Planning; Mozambique
JEL Codes: D83; J13; J16
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| correcting women's beliefs about pregnancy risk absent contraception (J13) | significant increase in contraceptive use (J13) |
| increasing expectations about pregnancy risk by 25 percentage points among women who underestimate this risk (J13) | raise contraceptive use by approximately 49 percentage points (J13) |
| correcting women's beliefs about pregnancy risk absent contraception (J13) | increase contraceptive use by 19 percentage points overall (J13) |
| aligning fertility preferences between women and their partners (J12) | increase contraceptive prevalence by 24 percentage points (J13) |
| increasing women's expectations of partner approval of contraception by 25 percentage points (J13) | raise contraceptive prevalence by 36 percentage points (J13) |