Perceived Social Acceptability of Young Women’s Contraceptive Use: A Randomized Information Experiment in Ghana and Burkina Faso

Adolescence and young adulthood are formative periods for sexual and reproductive health and emerging autonomy. During this period, young people navigate changing social roles and relationships, including expectations around gender and sexuality and ideas about what constitutes acceptable behavior. Social approval and perceived expectations may therefore shape not only how young women feel able to express their own views, but also whether they feel able to act on those views when engaging with sensitive topics such as contraception. Importantly, individuals respond to the social environment as they perceive it, which may differ from the underlying distribution of attitudes in that environment. Such discrepancies may lead individuals to make decisions partly on the basis of inaccurate perceptions of what others think or consider acceptable, even when these perceptions differ from their own preferences. In our study communities in Ghana and Burkina Faso, young people report high levels of acceptance of a young woman’s use of modern contraception if she wishes, but substantially underestimate the level of acceptance reported by other young people in the same cohort. We conduct an individually randomized survey experiment among adolescent girls and young women, embedded in an ongoing cohort study. Treated participants receive a short, site-specific video providing information about the measured share of young people in their community who support a young woman’s ability to use modern contraception if she wishes. We examine whether this information changes women’s social and health-seeking engagement with contraception and, among sexually active women for whom contraceptive behavior is immediately relevant, intentions to use contraception.