The Causal Effect of Improved Access to Postpartum Family Planning: Evidence from a Field Experiment in Urban Malawi

Mahesh Karra, Boston University
David Canning, Harvard University

We conduct a randomized controlled trial that identifies the causal impact of an intervention to improve access to family planning on contraceptive use, birth spacing, and women’s well-being in urban Malawi. A total of 2,143 married women aged 18-35 and who were either pregnant or had recently given birth were randomly assigned to an intervention arm or control arm. Women assigned to the intervention arm received three services over a two-year period: 1) six home visits from family planning counselors; 2) free transportation to a family planning clinic; and 3) reimbursement for family planning services. Preliminary findings show a 3.26 percentage point increase in postpartum contraceptive use in the treatment group after one year of exposure to the intervention. Finally, we find that the odds of short birth spacing is 54 percent lower after two years of exposure to the intervention.