Shared Decision-Making: Can Improved Counseling Increase Willingness to Pay for Modern Contraceptives?

Abstract

The Policy Research Working Paper Series disseminates the findings of work in progress to encourage the exchange of ideas about development issues. An objective of the series is to get the findings out quickly, even if the presentations are less than fully polished. The papers carry the names of the authors and should be cited accordingly. The findings, interpretations, and conclusions expressed in this paper are entirely those of the authors. They do not necessarily represent the views of the International Bank for Reconstruction and Development/World Bank and its affiliated organizations, or those of the Executive Directors of the World Bank or the governments they represent.

Bring a Friend: Strengthening Women's Social Networks and Reproductive Autonomy in India

“…These results contribute to the evidence base on the impact of vouchers on FP use (Bellows et al, 2015). While a number of previous studies have been unable to identify causal impacts, our findings are in line with some recent studies that rigorously estimate treatment effects using randomized experiments (e.g., Athey et al (2021); Karra and Zhang (2021); Tran et al (2020)). In particular, Athey et al (2021) find that offering long-acting reversible contraceptive methods for free or at a very small price in Cameroon increased adoption by 50 percent, which is similar to the 56 percent increase in method use that we observe in Column 1 of Table 5.…”

“…While a number of previous studies have been unable to identify causal impacts, our findings are in line with some recent studies that rigorously estimate treatment effects using randomized experiments (e.g., Athey et al (2021); Karra and Zhang (2021); Tran et al (2020)). In particular, Athey et al (2021) find that offering long-acting reversible contraceptive methods for free or at a very small price in Cameroon increased adoption by 50 percent, which is similar to the 56 percent increase in method use that we observe in Column 1 of Table 5. However, a crucial way in which our study differs from these papers is in explicitly recognizing that financial barriers are only one of the many constraints to FP use that women in our context face to accessing services; in this manner, our paper is similar to Ashraf et al (2014).…”

“…This finding is consistent with previous research showing that peer support can decrease stigma around health outcomes (Burke et al, 2019;Castro and Mang, 2022). Taken together, our results suggest that although offering women a voucher for their own use, a commonly used policy tool (Ashraf et al, 2014;Athey et al, 2021;Bellows et al, 2015;Karra and Zhang, 2021), may improve women's FP outcomes on average, such an intervention may be ineffective for women who are socially isolated, mobility constrained, and face intrahousehold opposition to FP use. 12 Only when we combine a voucher for a woman's own use with a voucher that encourages a woman's peers to participate do we observe improvements in FP outcomes for socially constrained women.…”

The effects of text reminders on the use of family planning services: evidence from a randomised controlled trial in urban Mozambique

“… 27 A third recent paper analysed an mHealth intervention designed to enhance contraceptive counselling (a tablet-based application) in Cameroon and found a very large positive effect on adoption of long-acting contraceptives. 28 Other papers have analysed the effect of mHealth interventions on knowledge or attitudes around contraception only. 16–20 …”

“…A second evaluation conducted in rural Kenya found a statistically significant increase in contraceptive uptake among women who received a series of SMS messages postpartum providing information about danger signs and family planning; only women who recently delivered were enrolled into the intervention 27. A third recent paper analysed an mHealth intervention designed to enhance contraceptive counselling (a tablet-based application) in Cameroon and found a very large positive effect on adoption of long-acting contraceptives 28. Other papers have analysed the effect of mHealth interventions on knowledge or attitudes around contraception only 16–20…”