Increasing access to contraceptive choice through targeted incentives: a cluster randomized controlled trial

Last registered on September 18, 2023
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Pre-Trial

Trial Information

General Information

Title
Increasing access to contraceptive choice through targeted incentives: a cluster randomized controlled trial
RCT ID
AEARCTR-0009020
Initial registration date
March 22, 2022

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
March 24, 2022, 4:39 PM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Last updated
September 18, 2023, 5:11 PM EDT

Last updated is the most recent time when changes to the trial's registration were published.

Locations

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Primary Investigator

Name
Carlos Paramo
Affiliation
University of California, Berkeley
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Other Primary Investigator(s)

PI Name
Maria Dieci
PI Affiliation
UC Berkeley
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PI Name
Paul Gertler
PI Affiliation
UC Berkeley
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Additional Trial Information

Status
In development
Start date
2022-04-04
End date
2024-06-01
Keywords
Firms & Productivity, Gender, Health
Additional Keywords
JEL code(s)
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
We investigate how targeted subsidies and information campaigns for long-acting injectable contraception (Sayana Press) and provider incentives impact initial uptake of Sayana Press, pricing and stocking decisions for contraceptive products in local markets, and sales. Following prior work on the effectiveness of subsidies to promote the adoption of new technologies and experience goods, we aim to test if subsidies lead to the adoption of Sayana Press as well as to study possible mechanisms such as learning, price channels, and information effects. We use a cluster randomized controlled trial in a network of independent pharmacies. Patient subsidies and pharmacist incentives will be randomized and compared against the status quo to evaluate their effectiveness in promoting adoption.
External Link(s)

Registration Citation

Citation
Paramo, Carlos, Maria Dieci and Paul Gertler. 2023. "Increasing access to contraceptive choice through targeted incentives: a cluster randomized controlled trial." AEA RCT Registry. September 18. https://doi.org/10.1257/rct.9020-2.0
Sponsors & Partners

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Experimental Details

Interventions

Intervention(s)
There will be 4 arms that will be randomized at the pharmacy (site) level. All sites will be users of a digital point-of-sale inventory management platform. Total subsidy and incentive amounts will be constant across 2 arms (T1 and T2) and higher for T3 (there is no financial incentive in the control arm).

(1) Control arm (C): pharmacy is an active user of the basic sales and inventory management digital platform, and pharmacy manages own stock of contraceptives.
(2) Patient subsidy arm (T1): The price of Sayana Press will be subsidized for the patient (50-80% subsidy).
(3) Pharmacy cost-reduction arm (T2): Providers will receive an incentive for each Sayana Press sale made, while being able to set their own prices.
(4) Pharmacy incentive arm (T3): Providers will receive a larger incentive relative to T1 and T2 for each Sayana Press sale made.
Intervention Start Date
2022-07-18
Intervention End Date
2023-03-06

Primary Outcomes

Primary Outcomes (end points)
The primary outcome is the uptake of Sayana Press.
Primary Outcomes (explanation)
Indicator for Family-Planning transaction including a Sayana Press sale.

Secondary Outcomes

Secondary Outcomes (end points)
Sales and prices of other contraceptive products, markups charged by pharmacies, and stocking of Sayana Press in study sites.
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
A sample of 137 eligible independent pharmacies in Western Kenya will be randomized into 4 study arms: (1) Control arm (2) Patient subsidy arm (3) Pharmacy cost-reduction arm (T2), and (4) Pharmacy incentive arm (T3).
Experimental Design Details
Not available
Randomization Method
Stratified randomization. Random seed will be set to equal the UC Berkeley IRB protocol number for the trial.
Randomization Unit
Cluster-level randomization at the pharmacy level stratified by current stocks of Sayana Press, Family Planning sale volumes and urbanicity.
Was the treatment clustered?
Yes

Experiment Characteristics

Sample size: planned number of clusters
137 Pharmacies
Sample size: planned number of observations
21,600 family planning product-transactions.
Sample size (or number of clusters) by treatment arms
35 control sites, 35 patient subsidy sites, 33 pharmacy pharmacy cost-reduction sites, 36 pharmacy incentive sites.
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
With 192 pharmacies, and 120 eligible family planning clients per site, and assuming an intra-class correlation (ICC) of 0.09 for SP uptake, we will be able to detect a minimum of a 5-percentage point increase in our main outcome between each group. This corresponds to a 62% of 1 SD change (SD = 0.08).
Supporting Documents and Materials
IRB

Institutional Review Boards (IRBs)

IRB Name
Committee for Protection of Human Subjects - 2, UC Berkeley
IRB Approval Date
2022-02-18
IRB Approval Number
CPHS #2021-11-14823
IRB Name
Strathmore University Institutional Ethics Review
IRB Approval Date
2022-01-28
IRB Approval Number
SU-IERC1233/21
Analysis Plan