SGER: Contraceptive Adoption and Household Wellbeing: A Field Experiment in Lusaka, Zambia

这一小笔探索性研究补助金(SGER)支持一项关于生育力的实验研究。这项研究使用了一种新的环境和实验设计，在赞比亚卢萨卡的一家计划生育诊所实施，以测试希望限制生育但不使用避孕措施的女性是否受到配偶对孩子的偏好或不愿使用节育措施的限制。虽然有强有力的坊间证据表明，配偶对生育率的控制可能会限制妇女的选择，但这是第一次可以测试这一重要因素在生育决定和结果中的程度的实地试验，方法是通过向妻子单独提供计划生育凭证(治疗A组)或向妻子在丈夫在场的情况下提供计划生育凭证(治疗B组)，随机抽查丈夫对妻子获得避孕措施的了解。赞比亚妇女可以获得注射避孕药具，但等待时间往往很长；这一实验设计通过发放代金券，保证在当地公共卫生诊所免费和立即获得这种方法，增加了上述两个治疗组中所有研究对象的可及性。通过这一设计创造了更多的机会，使拥有足够样本量和控制组的研究人员能够解决对生育和发育至关重要的其他问题。这项研究将在方法论上为文献做出贡献，通过获得长期的、以承诺为导向的避孕措施，首次对妇女对生育数量、时间和间隔的控制对妇女和儿童的影响进行实验估计。大多数关于生育选择和结果的实证研究都存在识别问题。虽然避孕对女性和家庭结果的影响是人口学和经济学文献中的一个中心问题，但还没有关于避孕措施获得的实验评估，准实验或回溯性研究存在常见的识别问题。因此，这一拟议的方法是对一个既定主题的新方法的宝贵应用。此外，将丈夫的知识随机化的分部分将阐明为生育决策提供信息的家庭内谈判动态。广泛的影响：更好地了解家庭内部采取避孕措施的决定因素以及避孕措施对家庭健康和福祉的影响，对计划生育政策的设计具有重要影响。此外，通过利用实验提供的机会来衡量同伴效应在避孕采用中的重要性，这项研究提供了证据，说明避孕知识通过社会网络传播到何种程度，从而改变生育标准。更好地了解采取避孕措施的决定因素和影响，对于决定各国政府应为资源有限的国家的计划生育提供的资源的数量和性质至关重要。

This Small Grant for Exploratory Research (SGER) supports an experimental study on fertility. The study uses a novel setting and experimental design, implemented with a family planning clinic in Lusaka, Zambia, to test whether women who desire to limit fertility but do not use contraception are constrained by spouses' preferences for children or unwillingness to use birth control. Although there is strong anecdotal evidence that spousal control over fertility can constrain women's choices, this is the first field experiment that can test the extent of this important factor in fertility decisions and outcomes, by randomizing husband's knowledge of his wife's access to contraception through providing family planning vouchers either to the wife alone (treatment group A), or the wife in the presence of her husband (treatment group B). Injectable contraception is available to women in Zambia but there is often a long wait; this experimental design increases access among all study subjects, in both treatment groups above, through the distribution of vouchers guaranteeing free and immediate access to this method at the local public health clinic. The increase in access created through this design allows the investigators, with sufficient sample size and a control group, to address other questions fundamental to fertility and development.This study will contribute methodologically to the literature by generating the first experimental estimates of the impact on women and children of increasing women's control over birth number, timing and spacing, through access to long-term, commitment-oriented contraception. Most empirical studies of fertility choices and outcomes suffer from identification problems. Although the influence of contraception on female and family outcomes is a central question in the demography and economics literatures, there have been no experimental evaluations of contraceptive access, and quasi-experimental or retrospective studies suffer from the usual identification problems. Hence, this proposed methodology is a valuable application of a new approach to an established topic. In addition, the sub-component that randomizes husbands' knowledge will shed light on intra-household bargaining dynamics that inform fertility decisions.Broader Impact: Better understanding of the intra-household determinants of contraceptive adoption and the impacts of contraception on family health and wellbeing has important implications for the design of family planning policies. In addition, by making use of the opportunity presented by the experiment to measure the importance of peer effects in contraceptive adoption, this study provides evidence on the extent to which contraceptive knowledge spreads through social networks to create changes in fertility norms. Improved understanding of both determinants and impact of contraceptive adoption is critical for deciding the amount and nature of resources that should be provided by governments for family planning in resource-constrained countries.