Cash Transfers and Contraceptive Use: A Regression Discontinuity Analysis

Adolescent girls' empowerment policy, health awareness, and decision-making: Evidence from the SABLA program in India

In India, adolescent girls are highly vulnerable, facing risks that hinder their healthy development into young women. India's Rajiv Gandhi Scheme for Empowerment of Adolescent Girls (SABLA) aims to address these challenges by promoting health awareness and encouraging decision-making autonomy, fostering women's development. Using data from the nationally representative India Demographic and Health Survey (IDHS) and exploiting exogenous variations in the program's rollout across districts and birth cohorts, we provide evidence that exposure to SABLA increases the likelihood of young female participants using family planning and modern family planning methods. Furthermore, it indicates that participants are more likely to adopt a healthier diet, characterized by increased consumption of green leafy vegetables and reduced intake of fried foods. Additionally, the program empowers participants to have control over their financial resources. The findings also reveal a significant reduction in the likelihood of anemia among women who were exposed to the program. Notably, our results suggest that SABLA contributes to delaying women's marriage and their first childbirth. We find that women exposed to the program have fewer children than their counterparts and face fewer pregnancy losses. To account for COVID-19 disruptions, we include a COVID dummy variable. While the pandemic affected family planning, nutrition, and anemia, SABLA's positive impact on health and empowerment remains strong. Notably, it did not affect women's role in household decision-making, highlighting its lasting effect on empowerment.

Contraception use and satisfaction among mothers with low income: Evidence from the Baby's First Years study

OBJECTIVES

Low income can lead to limited choice of and access to contraception. We examine whether an unconditional cash transfer (UCT) impacts contraceptive use, including increased satisfaction with and reduced barriers to preferred methods, for individuals with low income.

STUDY DESIGN

Baby's First Years is a randomized control study of a monthly UCT to families with low incomes. The study enrolled 1000 mothers at the time of childbirth across four US sites in 2018-2019; 400 were randomized to receive a UCT of $333/mo and 600 were randomized to receive $20/mo for the first years of their child's life. We use intent-to-treat analyses to estimate the impact of the cash transfer on contraception use, satisfaction with contraception method, and barriers to using methods of choice.

RESULTS

Over 65% of mothers reported using some type of contraception, and three-quarters reported using the method of their choice. We find no impact of the UCT on mothers' choice of, satisfaction with, or barriers to contraception. However, the cash transfer was associated with trends toward using multiple methods and greater use of short-term hormonal methods.

CONCLUSIONS

We find high levels of satisfaction with current contraceptive use among mothers of young children with low income. Receipt of monthly UCTs did not impact contraception methods, perceived barriers to use, or satisfaction. Yet, 25% were not using the method of their choice, despite the provision of cash, indicating that this cash amount alone may not be sufficient to impact contraceptive use or increase satisfaction.

IMPLICATIONS

Satisfaction with contraception use among low-income populations may be higher than previously documented. Nevertheless, provision of modest financial resources alone may not sufficiently address access, availability, and satisfaction for individuals with low-incomes of childbearing age. This suggests the importance of exploring how other nonfinancial factors influence reproductive autonomy, including contraceptive use.

The impact of unconditional cash and food assistance on contraceptive expenditure of rural households in Coastal Bangladesh: Evidence from fuzzy RDD

This study investigates the impact of unconditional cash and food (UCF) assistance on the monthly contraceptive expenditure of rural households in coastal Bangladesh using a fuzzy regression discontinuity design (RDD). Eligibility for UCF assistance was based on the running variable of land ownership in acres. We used eligibility as an instrumental variable to estimate the local average treatment effect of UCF assistance on contraceptive expenditures. The results show that UCF assistance results in increases in monthly contraceptive expenditures.