Impact of the ‘Protecting Life in Global Health Assistance (PLGHA)’ Policy on Health Service Delivery in sub-Saharan Africa

Nina Brooks, University of Minnesota
Matt Gunter, University of Minnesota
Eran Bendavid, Stanford University
Elizabeth Boyle, University of Minnesota
Kathryn Grace, University of Minnesota, Twin Cities
Grant Miller, Stanford University and National Bureau of Economic Research (NBER)

The Trump Administration reinstated and expanded the Mexico City Policy (MCP), requiring all international organizations that receive any type of U.S. global health assistance to certify that they do not use any funds (U.S. or others) to promote or discuss abortion. This vastly expanded policy, known as the Protecting Life in Global Health Assistance (PLGHA), covers $11 billion of U.S. aid for programs well beyond family planning and reproductive health, such as HIV/AIDS, maternal and child health, and malaria. Existing evidence on prior implementations of the MCP suggests that when the policy’s funding restrictions are in effect abortions rise because contraceptive supplies are reduced due to the policy. In this analysis, we directly test this hypothesis and empirically assess PLGHA’s impact on health service delivery and reproductive health outcomes in sub-Saharan Africa using the Performance Monitoring for Action (PMA) survey data on health facilities and women. Using a difference-in-difference approach to isolate changes in outcomes that can be attributed to the implementation of PLGHA, this analysis will provide key insights into the mechanisms proposed in previous studies, as well as a more comprehensive assessment of PLGHA’s impacts.

Keywords: Policy evaluation, Family planning and contraception, Sexual and Reproductive Health and Rights, Cross-country comparative analyses

See paper.

  Presented in Session 76. Abortion as a Programme and Policy Priority