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Family Planning Services and Human Capital Growth: Experimental Evidence from Urban Malawi

Mahesh Karra, Boston University
David Canning, Harvard University

We conduct a randomized control trial that improves pregnant and postpartum women's contraceptive knowledge and access through a comprehensive family planning package that consisted of counseling, free transport to a clinic, and financial reimbursement for family planning services for a two-year period. We use this experiment to test an extension of Becker's theory of fertility that accounts for the uncertainty in fertility that many low-income couples face. We study 720 children born to women who were pregnant at enrollment and find that children born to mothers assigned to the intervention arm were 0.23-0.26 standard deviations taller for their age and were 6.7-7.2 percent less likely to be stunted at first year follow-up. We find that children born to mothers assigned to the intervention arm scored 0.1 standard deviations higher on a caregiver reported measure of cognitive development at second year follow-up. Using a causal mediation analysis, we show that 20-30 percent of these effects can be explained by increases in healthcare usage. Within the extended theory of fertility, our results suggest that reduced fertility uncertainty induces couples to increase investment in the health of their children and highlight the substitutability of child quality and quantity in parental preferences.

Keywords: Family planning and contraception, Children and youth, Randomized controlled experiments, Causal analysis / Causal estimation

See paper.

  Presented in Session 31. Contraceptive Dynamics: Supply Side Issues