Poster #27 - Does increased availability of modern contraceptives reduce unwanted pregnancies? - Evidence from Senegal

• In Event: Friday Poster Reception

Abstract

Family planning policies in developing countries have so far largely focused on increasing the supply of contraceptive commodities. However, evidence on the effectiveness of supply-side interventions in boosting modern contraceptive use and reducing excess fertility remains mixed. This study aims to estimate the causal effects of increased availability of modern contraceptives on use and fertility outcomes in Senegal, where rates of unwanted pregancies are among world's highest, exploiting the staggered implementation of the Informed Push Model (IPM) program - a public-private partnership which strengthened contraceptives supply chains in Senegal since 2012. Using spatially merged individual and health facility data from the Demographic and Health Surveys (DHS) (1992-2023) and Service Provision Assessment (SPA) (2012-2017) surveys in Senegal, I conduct both individual-level analysis using an 2SLS-IV design and population-level analysis using a two-stage difference-in-difference (2SDiD) design. Both analyses have found that increased availability of modern contraceptives has an overall null effect on prevalence of use in the population but a significant effect in reducing unwanted pregnancies. Having one additional method stocked across facilities in a woman's arrondissement reduces the likelihood that a her last pregnancy was unwanted by 6.88 percentage points on average; however, this effect is mainly driven by women in their thirties and is null among married adolescents. The findings so far suggest that the effect of increased availability of modern methods in reducing unwanted pregnancies is highly differentiated by age; and is achieved through improving the quality of use (e.g. aiding switch to a more reliable method among existing users) and not through reducing unmet need. Implications for policy include that alternative strategies are needed to reduce unwanted pregnancies among adolescent and hard-to-reach women.

Author

• Jiayuan Wang, University of Washington
  Presenting Author