Experimental Design
We conduct a randomized control trial with two treatment arms and an active control group. Every treatment group attended an on-campus workshop during which participants consented and baseline data were collected. All workshops were run by the same team of facilitators, who were employees of our program.
The content of the workshop differed depending on which group a student was randomized into. For the control group, facilitators informed students about the location of a youth-friendly health clinic that was roughly 25 minutes walk from campus. In the first treatment arm, a non-coercive conditional cash transfer (CCT), students were given the same information as students in the control group and a small payment for visiting said clinic (but not to take-up contraceptives or any other medical care). In the second treatment arm, in addition to receiving the CCT, students received targeted information intended to counter the incorrect belief that hormonal contraceptives cause permanent infertility.
We contacted 2703 potential participants at UNZA between August 2022 and April 2023 and invited them to participate in the study. Invitees were recruited using a variety of different strategies, ranging from e-mails to in-person recruitment. During recruitment, students were asked whether they were interested in attending a workshop (all study arms attended on-campus workshops) to learn about women's health. Students were informed that the workshop was part of an academic study on women's health and that they would receive airtime for their participation in the workshop and subsequent data collection. If students expressed interest and passed our inclusion criteria (they were enrolled at UNZA and between 18-25 years old), they were provided with a link to sign up for an on-campus workshop. At the time of sign-up, they were randomized into a treatment arm and only shown workshops belonging to their treatment arm.
To be included in the study, invitees had to attend their assigned workshop during which students provided informed consent and baseline data were collected. Out of the 2,703 invitees, 1,508 ultimately attended a workshop and consented to participate in the study: 508 Control, 486 CCT, and 514 Fertility. Attrition was balanced by treatment arm.
We use two datasets to evaluate the intervention. The first data set was collected in partnership with our partner clinic by an enumerator based at the clinic. It contains information on the services received at the clinic. We collected information not only on whether students requested any contraceptive services but also which type they requested. We also collected information on whether they took up any other healthcare related services, such as sexually transmitted infection (STI) tests and pregnancy tests.
The second data set comes from smartphone surveys completed by participants every two weeks after the intervention for up to 6 months. The first of these mobile surveys, which served as a baseline, was conducted at the workshop for all participants. Participants were sent the survey link to their mobile phones and asked to complete the survey upon receipt. This allowed the facilitators to ensure that all participants were receiving the links, solve any technical issues, and answer any questions about the survey. Following the workshop, participants were sent a new survey link on their mobile phone every two weeks on Friday evenings. Each survey had a maximum length of fifteen minutes. Every survey asked about contraceptive use, sexual encounters in the last two weeks, partner information, pregnancy, and clinic visits, forming a panel of data on these key outcomes. Importantly, unlike the clinic data, which measures contraception take-up, the survey data measures actual usage. For some contraceptives, such as the pill, these measures may differ since a young woman can take-up the pill at the clinic but then fail to use it or delay using it until she starts having sex. In addition, different survey rounds included rotating questions on beliefs, attitudes and fears around contraceptives, child-bearing and marriage, enabling us to explore additional outcomes and the mechanisms underlying the responses we observe.