Intervention (Hidden)
During the baseline interview, women will receive a detailed informative brochure on family planning and on the benefits of healthy timing and spacing of births as well as general information on modern family planning methods. The brochure will be provided to women by the field managers, who will be trained by the Delhi School of Economics.
The three intervention arms are as follows:
1. Solo- Voucher Arm:
Women assigned to the solo-voucher arm will be given a voucher package for receiving family planning and reproductive health services at our partner family planning clinic, the ADC Clinic in Chandwak, Jaunpur. This voucher package will grant access to a wide range of contraceptive methods and services at the ADC Clinic which is known to be a high-quality family planning clinic with well-trained staff, relatively low waiting times, and a full range of contraceptive methods. As part of this package, each woman assigned to the solo-voucher arm will receive one free initial family planning consultation at the ADC Clinic. In addition, she will be provided a voucher of INR 2,000 (about $30 USD) that can be used to cover the costs of family planning services at the ADC Clinic over a 10-month period. Specifically, the voucher can be used to cover costs associated with procuring contraceptive methods as well as other family planning-related costs, such as the treatment and management of contraceptive-related side effects. This voucher will be valid only for 10 months starting on the day it is given to the woman. A woman can use the voucher over multiple clinic visits; however, the voucher will only cover up to INR 2,000 of her family planning-related expenses over all of her visits during these 10 months. A woman will be responsible for covering any expenses that are not related to family planning as well as for any family planning services that exceed her Rs.2,000 limit over the intervention period.
2. Bring-a-Friend (BAF) Arm:
Similar to women assigned to the solo-voucher arm, women assigned to the BAF arm will also receive a free first consultation at the ADC Clinic and will be provided with a voucher of INR 2,000 that can be used to obtain family planning services at the ADC Clinic over a 10-month period. In addition, if a woman assigned to the BAF arm chooses to bring friends with her to the ADC Clinic, her friends will also be eligible to receive the same voucher of INR 2,000 for any family planning services that they take up over the 10-month intervention period. A woman assigned to the BAF arm may bring up to two friends during each visit and may either bring different friends or the same friend(s) for each subsequent visit. Each friend that the BAF woman brings will receive coverage in the amount of INR 2,000 for her family planning expenses over all of her visits to the ADC Clinic over the intervention period. Any expenditures that are not related to family planning or any family planning expenditures that exceed INR 2,000 over the course of the 10-month intervention period that are incurred by either the BAF woman or her friend will have to be covered out of pocket.
No intervention woman can receive more than INR 2,000 in total in coverage for family planning-related services over the course of the intervention period, and no woman can redeem more than one voucher for family planning at any time (i.e., a woman cannot take advantage of a solo-voucher as well as a BAF voucher and double her coverage limit over the course of the intervention period).
At least one of our field managers will be stationed at the clinic throughout the 10-month intervention period to record all women who come to the clinic and will collect information on the friends whom they bring, whom else they asked (or who else asked them) to come along, and the services that they used at the clinic. All activities over the intervention period, both by voucher recipients and their peers, will be monitored, recorded, and linked back to the social network data that were collected at baseline. New peers who are found to have not been identified by the voucher recipient during the baseline social network mapping will be registered on a rolling basis into the network database at the clinic by the field manager, and their detailed socio-demographic information will be collected so as to be able to track their expenditure and voucher coverage over the intervention period.
In order to be able to redeem the voucher amount for reimbursement for services, a woman (or the friend of a BAF woman) must have received a family planning related service at the ADC clinic on that day. However, a BAF woman’s voucher is not contingent on her friends receiving family planning services at the ADC Clinic. Similarly, the voucher for the friend of a BAF woman is not conditional on the BAF woman receiving family planning services at the ADC clinic. Any unused voucher amount will not be disbursed at the end of the intervention period.
Transportation Costs: The field manager will reimburse solo-voucher and BAF women (and for the BAF women, their friends whom they bring) for transportation to the clinic at a flat rate of INR 40 per person per visit, and the total reimbursement over the course of the program period will not exceed INR 120 per person (i.e., transportation coverage for a maximum of 3 visits per person). The transportation reimbursement will be provided to the women at the end of their visit to the ADC Clinic by the field manager, who will be stationed at the ground floor of the clinic. Any transportation costs that exceed INR 40 per visit for a total of 3 visits per person will not be covered. However, a woman’s transportation reimbursement is not contingent on her friends receiving family planning services at the ADC Clinic. Similarly, the transportation reimbursement for the friend of a BAF woman is not conditional on the BAF woman receiving family planning services at the ADC clinic. Reimbursement for transportation to the ADC Clinic will only be provided during the clinic’s daily working hours, which are between 8 AM and 6 PM daily. Any unused voucher or transportation reimbursement amounts will not be disbursed at the end of the intervention period.
3.Control (No-Voucher) Arm: Women in the control arm will receive only the information brochure (at the baseline survey) and they will only be re-contacted by the research team at the time of the follow-up survey.