Causes and consequences of teen childbearing: Evidence from a reproductive health intervention in South Africa

We use a natural experiment to estimate the causal impact of a public health intervention aimed at reducing teenage childbearing. The geographic and timing variation in the rollout of the South African National Adolescent Friendly Clinic Initiative (NAFCI) in the early 2000s provides a plausibly exogenous increase in reproductive health knowledge and clinical access for teens. We investigate the causal pathway from the intervention’s initial impact on early-teen childbearing to subsequent consequences for later-life outcomes of prime policy interest — education, employment and child health. Our empirical strategy uses GPS data from the National Income Dynamics Study to geolink women’s location of residence during adolescence to the location and timing of the rollout. Our results show that living near a NAFCI clinic during adolescence delayed childbearing, substantially lowering the likelihood of early teen childbearing. We estimate that adolescents who had access to NAFCI completed more years of schooling and, consistent with increased human capital investments, earn substantially higher wages as young adults. Finally, children born to women who had access to youth-friendly services as teens show substantial health advantages, indicating a strong intergenerational benefit of delaying early teen childbearing in a developing country context.