Fertility, Child Work, and Schooling Consequences of Family Planning Programs: Evidence from an Experiment in Rural Bangladesh

Family planning programs can significantly decrease lifetime fertility, but have no impact on child work and schooling.

Introduction

Economists and social scientists have long believed that family planning programs can reduce fertility and influence other household decisions. By empowering women to have more control over their fertility, family planning can provide them more with greater bargaining power in the inter-household decision-making process over children. Various programs have provided family planning education to couples, or to women or men on their own. In the Matlab Family Planning and Maternal Child Health (FP-MCH) program in Bangladesh, 70 villages were assigned to participate in ICDDR,B’s family planning program, while 72 villages continued on with the traditional government family planning program. In the treatment villages, trained female outreach workers visited all households once every 2 weeks to provide information to women about contraceptives and the management of side effects. They were also able to provide nonclinical methods (oral contraceptives, condoms, and foam tablets) and administered depo-medroxyprogesterone acetate (DMPA) injections. This study analyzed the outcomes of ICDDR,B’s program, measuring whether household behavior changed as a consequence of the family planning program, particularly on women’s fertility outcomes, children’s schooling, and children’s labor force participation.

Findings

In rural Bangladesh, villages received either a special intensive family planning program or government family planning services over an 18-year period from 1978 to 1996.

  • The intensive family planning program reduced lifetime fertility by 14 percent. Women used modern contraceptive methods, primarily DMPA injections, to space children and postpone births.
  • Boys in treatment villages are about 13 percent more likely to participate in work activities than boys in control villages. There was no significant change on girls’ labor force participation.
  • The program had no impact on school enrollment for either boys or girls. However, girls’ enrollment remained higher than boys’ enrollment in all villages.  

In short, this intensive family planning program reduced lifetime fertility, but did not reduce children’s labor force participation or increase children’s school enrollment.

Methodology

The intensive family planning program was introduced in 70 villages in the Matlab district in rural Bangladesh in 1978. The treatment villages received the family planning program from the International Center on Diarrhoeal Disease Research, Bangladesh (ICDDR,B), while 72 control villages received the less intensely offered government family planning services, where the standard of care was not actively or intensely offered to women. All married women residing in treatment villages participated in the program. The ICDDR,B program consisted of bi-weekly home visits by female outreach workers, who provided information and several contraceptive methods.

This study uses data from the Matlab Health and Socioeconomic Survey, covering 18 years from 1978 to 1996. The analysis is based on data for 139 villages (70 treatment villages and 69 control villages), 4,124 ever-married women, and 2,500 children aged 10 to 16.

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