Household Bargaining and Excess Fertility: An Experimental Study in Zambia

Abstract: This paper tests the role of spousal discordance in explaining unmet need for contraception and excess fertility through a field experiment with a large public family planning clinic inLusaka, Zambia. We randomly assigned married women to receive a voucher, which guaranteed ease of access to a range of modern contraceptives, either alone (Individual treatment) or in the presence of their husbands (Couples treatment). The voucher amounted to a sudden and unexpected reduction in the price of fertility control, and the manipulation gave a random set ofwomen greater ability to conceal take-up of contraception from their husbands. Women in the Individual treatment were 19% more likely to visit a family planning nurse and 27% more likely to ask for a concealable form of contraception, leading to a 59% reduction in unwanted births9-14 months later. These findings provide evidence of inefficiencies in household bargainingover fertility, which have the potential to generate a higher level of fertility than is socially optimal. These findings also help explain why some e fforts to involve men in family planning have been unsuccessful in reducing unmet need.