This study seeks to identify the causal impact of a family planning intervention on fertility, maternal and child health outcomes, and downstream economic outcomes by means of a randomized control trial. The proposed trial will be conducted in Lilongwe, Malawi, where total fertility is high, contraceptive prevalence is low, and access to services is poor. As part of the intervention, women in the study sample who are randomly assigned to the intervention arm will receive a multicomponent family planning package that includes:
1. a family planning information package and private counseling visits;
2. free transportation to a family planning clinic with low waiting times; and
3. financial reimbursement for family planning services, including out of pocket expenditures related to family planning care and treatments that are received at the family planning clinic (e.g. medications, contraceptive methods, consultation fees, exam fees, treatment of contraceptive-related side effects), and free over-the-phone consultations and referral services from a doctor in the event that she experiences contraindications or side effects related to her use of family planning
Short-term outcomes of interest include modern contraceptive use, intention to use, and knowledge of family planning. Intermediate outcomes include fertility outcomes (parity, birth spacing), changes in desired fertility, unmet need, and outcomes associated with maternal and child health, including safe pregnancy, child birth height and weight, and nutritional status. Longer-term outcomes include educational attainment, labor market and employment outcomes, income, and household expenditure.