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Exploring user-centered counseling in contraceptive decision-making: evidence from a field experiment in urban Malawi

Mahesh Karra, Boston University
Kexin Zhang, Boston University

Family planning programs have increasingly begun to adopt user-centered approaches to counseling, however, little is known about how user-centered approaches to family planning shape women’s preferences and characterize women's choices. In this study, we explore how a woman’s contraceptive decision-making process is shaped by 1) the number and types of contraceptive methods presented to her; and 2) the presence of her husband / male partner at the time of counseling. A total of 782 women were randomized to one of four treatment arms and received a counseling session. Following the counseling session, women were offered free transport and family planning services at a clinic for a one-month period. Our findings show that women who received targeted counseling were more likely to change their stated ideal contraceptive method but were less likely to be using their stated ideal method at follow-up, and were therefore more unsatisfied with their currently used method. On the other hand, women who were encouraged to invite their husbands to the counseling session were less likely to change their ideal method but were more likely to switch from their currently used method over time and were more likely to pick up their stated ideal method at follow-up.

Keywords: Family planning and contraception, Fertility and childbirth, Randomized controlled experiments, Economic analysis

See extended abstract.

  Presented in Session P9.