Networks and Global Health: Experimental Evidence of Women’s Social Networks, Reproductive Health, and Well-Being

Women who are administered the baseline surveys will be randomly assigned to one of three treatment arms: 1) a no-voucher group (50%), 2) a solo-voucher group (25%), and 3) a “bring-a-friend” (BAF) group (25%). All participants will receive an information brochure that describes the benefits of family planning, healthy birth spacing, and timing of pregnancy. Women who are randomly assigned to the solo-voucher and BAF groups will also receive a voucher for discounted access to family planning services at a high-quality private clinic. In addition, women who are randomly assigned to the BAF group will be encouraged to bring a friend who may also be, in consultation with a doctor at the FP clinic, eligible to receive the same voucher for family planning as the treated woman.

2018-09-04

2018-09-30

1. Attitude/Knowledge of Family Planning, including: knowledge of family planning; knowledge of birth spacing and timing; and perceptions toward contraception (including intentions to use).
2. Contraceptive Use, including: changes in contraceptive prevalence; changes in method mix; and adherence to methods (compliance, discontinuation).
3. Pregnancy and Fertility Outcomes, including: pregnancy status; parity; delivery in a facility; months since last birth; wantedness of last birth; and intentions to become pregnant in future.
4. Social Network Outcomes: including: network formation, peer effects, centrality, etc.
5. Intervention Uptake: use of the voucher, number of peers that were brought to the clinic, etc.

Conducted 2-month long baseline survey among eligible women, where eligible women are those who:
1. are 18-30 year old;
2. are currently married;
3. have at least one child;
4. are not sterilized nor has had a hysterectomy;
5. are neither pregnant nor are more than six months postpartum at the time of the screening; and
6. live in one of the survey sites.

We visited 2,781 household in adjacent villages for the study and found an estimate of 671 households that had at least one woman with these characteristics. We interviewed the youngest woman in case there was more than one eligible woman present in the household at the time of the survey. Data on women’s social networks, background characteristics, reproductive and contraceptive histories, and other information was collected as part of the baseline survey. The field enumerators also distributed, right after the interview, to all participants an information brochure that describes the benefits of family planning, healthy birth spacing, and timing of pregnancy. The information brochure was not accompanied by a counseling session. As part of the baseline survey, we collected identifying information (addresses, phone numbers, household GPS locations, etc.) needed for the follow-up. We also collected photographs of interviewed women to construct a photo album that will be used to validate mentioned network ties.

Next, we randomized the sample of eligible women into the three treatment arms. Doing the randomization after the baseline survey allowed us to balance on baseline covariates.

Following randomization, women who are assigned to the voucher and BAF arms will receive a visit from a field worker, who will inform them about the services that are available to them as part of their respective intervention and who will provide them with the voucher for access to family planning at our partner family planning clinic, the ADC Clinic in Chandwak, Jaunpur. Intervention field workers will also be able to use the photo album in order to verify the baseline social network information, particularly, the network ties and alters that were provided by women assigned to the voucher and BAF arms. Women will be able to use the vouchers once we complete the randomization and the photo verification process which we expect to implement within 1 to 2 weeks.

This will be followed by a 10-month-long intervention period during which women who are provided with vouchers may redeem them at the ADC Clinic. During this period, a field manager will monitor and record data on all clinic visits by women in the sample.

Following re-hiring and training of field staff, we will implement a 2-month-long endline survey to capture changes in family planning practices and attitudes.

We randomized women into intervention and control arms using stratification methods, in which intervention assignment was balanced according to the following baseline characteristics: village, current use of family planning, educational attainment, desire for another child, and number of peers mentioned in our social networks module.

Household

No

671 households (one woman per household)

671 households (one woman per household)

Control = 350 women
Solo-voucher Treatment = 156 women
Bring-a-friend Treatment = 165 women

Please see the attached document for detailed power calculations we conducted before the baseline survey. However, since then, we managed to survey more women than we had planned in our baseline survey.