Resolution of Uncertainty through Testing: The Impact of Pregnancy Tests on Reproductive and Maternal Health Beliefs and Behaviors

2017-07-01

2018-06-30

Take-up of contraceptives (by type of method), perceived pregnancy status or degree of uncertainty about pregnancy status, and receipt of ANC during the follow-up period as well as value of pregnancy test (Willingness to pay).

We will construct measures for the following FP-related outcomes: use of oral contraceptives, use of injectables, use of other short-acting method, and use of long-active reversible method. For ANC-related outcomes, we will measure any ANC visit, gestational age at first ANC visit, and number of ANC visits. Willingness to pay is computed by Becker-DeGroot-Marschak (BDM) or/and Take it or leave it (TIOLI) method

Following baseline data collection, half of the sample will be provided with a home pregnancy test to assess how resolving uncertainty about pregnancy status affects beliefs and behaviors.

We will conduct two interventions at baseline:
1. First, following baseline data collection, half of the sample (300 of the 600 women uncertain of pregnancy status at baseline) will be provided with a home pregnancy test to assess how resolving uncertainty about pregnancy status affects beliefs and behaviors. The test consists of a simple dip-strip pregnancy test (dipped into a receptacle of urine) and an informational pamphlet explaining how and when to use the test and interpret the results. By randomly allocating access to free home pregnancy tests at baseline, we will be able to compare how access to and experience with home pregnancy tests affects a) beliefs about pregnancy status, b) willingness to pay and value of additional pregnancy tests at baseline and endline, and c) use of FP services or ANC services. We hypothesize that access can affect behavior through both experience and acquiring information.

2. Second, we will provide a free pregnancy tests to half of the respondents, randomly selected and stratified by intervention #1 for use in the future.

In the last round of data collection, we will elicit WTP for pregnancy tests among all women. We will use the price indicated as an outcome measure; we expect women with experience using the product (that is, those randomly assigned the free test at baseline) to be WTP.
Women who receive a test for free will be able to test for pregnancy in their home if they experience a period of uncertainty or suspect a pregnancy. Pregnant women will also be eligible to purchase a pregnancy tests to assess their demand for these tests.
At endline, we will give money as a token of appreciation for their participation in the study, which they can choose to use towards purchasing the home pregnancy tests. Pregnancy tests will then be offered to women for a randomly assigned price ranging from free to a moderate subsidy.

Random number generator done in office by a computer

Individual

No

No culster

600 women - not pregnant or uncertain of pregnancy status, at risk of pregnancy, and 100 pregnant women

150 women, offer free pregnancy test at baseline and given a pregnancy test kit for future use
150 women, offer free pregnancy test at baseline
150 women, given a pregnancy test kit for future use
150 women, control group. No intervention.

According to the DHS 2011 in Uganda, 19.22% of people use modern contraceptive in South West region (sample weighted). Following the power calculation of two proportion test (standard deviation automatically calculated by mean since the outcome is binary variable), the treatment group has to have 30.62% take up of family planning with power set at 0.9. This is the 11.41 percentage points increase from the baseline.