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The effect of family planning exposure on fertility choices and reproductive health care in rural Pakistan

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  • Khan, Qaisar
  • Wang, Shun

Abstract

This paper investigates whether family planning exposure mainly through the Lady Health Worker Program has had any effect on women’s fertility choices and use of reproductive health care service in rural Pakistan, using the 2013 Pakistan Demographic and Health Survey (PDHS). Exploiting variations in the program intensity across regions, we conduct instrumental variables (IV) estimation on the impact of family planning exposure on women’s fertility preferences and reproductive behaviors. Our analysis shows that even in the presence of strong son preferences in Pakistan, increasing family planning exposure reduces women’s incentive to have additional children. Moreover, family planning exposure is associated with more antenatal care visits, more deliveries performed by skilled professionals, and a greater chance of delivery at the health center. Finally, we examine the heterogeneity in the effect on fertility preference by age group and education level, and find that the effect is mainly significant for the educated and young women.

Suggested Citation

  • Khan, Qaisar & Wang, Shun, 2021. "The effect of family planning exposure on fertility choices and reproductive health care in rural Pakistan," Journal of Asian Economics, Elsevier, vol. 73(C).
    • Handle: RePEc:eee:asieco:v:73:y:2021:i:c:s1049007821000129
    DOI: 10.1016/j.asieco.2021.101283
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    References listed on IDEAS

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    1. John Bongaarts, 2013. "The Implementation of Preferences for Male Offspring," Population and Development Review, The Population Council, Inc., vol. 39(2), pages 185-208, June.
    2. John B. Casterline & Steven W. Sinding, 2000. "Unmet Need for Family Planning in Developing Countries and Implications for Population Policy," Population and Development Review, The Population Council, Inc., vol. 26(4), pages 691-723, December.
    3. Sultan, M. & Cleland, J.G. & Ali, M.M., 2002. "Assessment of a new approach to family planning services in rural Pakistan," American Journal of Public Health, American Public Health Association, vol. 92(7), pages 1168-1172.
    4. Batool Zaidi & S. Philip Morgan, 2016. "In the Pursuit of Sons: Additional Births or Sex-Selective Abortion in Pakistan?," Population and Development Review, The Population Council, Inc., vol. 42(4), pages 693-710, December.
    5. Pritchett, Lant H. & DEC, 1994. "Desired fertility and the impact of population policies," Policy Research Working Paper Series 1273, The World Bank.
    6. Mitrut, Andreea & Tudor, Simona, 2018. "Bridging the gap for Roma: The effects of an ethnically targeted program on prenatal care and child health," Journal of Public Economics, Elsevier, vol. 165(C), pages 114-132.
    7. Seema Jayachandran, 2014. "Does Contraceptive Use Always Reduce Breast-feeding?," Demography, Springer;Population Association of America (PAA), vol. 51(3), pages 917-937, June.
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    Cited by:

    1. Frank Götmark & Malte Andersson, 2023. "Achieving sustainable population: Fertility decline in many developing countries follows modern contraception, not economic growth," Sustainable Development, John Wiley & Sons, Ltd., vol. 31(3), pages 1606-1617, June.

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    More about this item

    Keywords

    Family planning; Fertility choice; Reproductive health care; Lady health worker program; Son preference; Pakistan;
    All these keywords.

    JEL classification:

    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth
    • J18 - Labor and Demographic Economics - - Demographic Economics - - - Public Policy
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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