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Evaluating the Mexico city policy: How US foreign policy affects fertility outcomes and child health in Ghana

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  • Jones, Kelly M.

Abstract

US development assistance represents a significant source of funding for many population programs in poor countries. The Mexico City policy, known derisively as the global gag rule, restricts activities of foreign nongovernmental organizations (NGOs) that receive such assistance. The intent of the policy is to reduce the use of abortion in developing countries—a policy that is born entirely of US domestic politics and that turns on and off depending on the political party in power. I examine here whether the policy achieves its aim, and how the policy affects reproductive outcomes for women in Ghana. Employing a woman-by-month panel of pregnancies and woman fixed effects, I estimate whether a given woman is less likely to abort a pregnancy during two policy periods versus two nonpolicy periods. I find no evidence that any demographic group reduces the use of abortion as a result of the policy. On the contrary, rural women significantly increase abortions. This effect seems to arise from their increased rate of conception during these times. The policy-induced budget shortfalls reportedly forced NGOs to cut rural outreach services, reducing the availability of contraceptives in rural areas. The lack of contraceptives likely caused the observed 12 percent increase in rural pregnancies, ultimately resulting in about 200,000 additional abortions and between 500,000 and 750,000 additional unintended births. I find that these additional unwanted children have significantly reduced height and weight for age, relative to their siblings. Rather than reducing abortion, this policy increased pregnancy, abortion, and unintended births, resulting in more than a half-million children of significantly reduced nutritional status.

Suggested Citation

  • Jones, Kelly M., 2011. "Evaluating the Mexico city policy: How US foreign policy affects fertility outcomes and child health in Ghana," IFPRI discussion papers 1147, International Food Policy Research Institute (IFPRI).
  • Handle: RePEc:fpr:ifprid:1147
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    Cited by:

    1. Finlay, Jocelyn E., 2021. "Women’s reproductive health and economic activity: A narrative review," World Development, Elsevier, vol. 139(C).
    2. Bloom, David E. & Luca, Dara Lee, 2016. "The Global Demography of Aging: Facts, Explanations, Future," IZA Discussion Papers 10163, Institute of Labor Economics (IZA).
    3. J.M. Ian Salas, 2012. "Consequences of withdrawal : Free condoms and birth rates in the Philippines," UP School of Economics Discussion Papers 201220, University of the Philippines School of Economics.
    4. Grant Miller & Christine Valente, 2016. "Population Policy: Abortion and Modern Contraception Are Substitutes," Demography, Springer;Population Association of America (PAA), vol. 53(4), pages 979-1009, August.
    5. Bloom, D.E. & Luca, D.L., 2016. "The Global Demography of Aging," Handbook of the Economics of Population Aging, in: Piggott, John & Woodland, Alan (ed.), Handbook of the Economics of Population Aging, edition 1, volume 1, chapter 0, pages 3-56, Elsevier.
    6. Erasmus Kersting & Christopher Kilby, 2021. "Do domestic politics shape U.S. influence in the World Bank?," The Review of International Organizations, Springer, vol. 16(1), pages 29-58, January.
    7. Herrera-Almanza, Catalina & Rosales-Rueda, Maria F., 2020. "Reducing the Cost of Remoteness: Community-Based Health Interventions and Fertility Choices," Journal of Health Economics, Elsevier, vol. 73(C).
    8. Bhalotra, Sonia R. & Clarke, Damian & Mühlrad, Hanna & Fernandez Sierra, Manuel, 2021. "US Presidential Party Switches Are Mirrored in Global Maternal Mortality," IZA Discussion Papers 14915, Institute of Labor Economics (IZA).

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    More about this item

    Keywords

    abortion; child health; fertility; Foreign aid;
    All these keywords.

    JEL classification:

    • F35 - International Economics - - International Finance - - - Foreign Aid
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth
    • O19 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - International Linkages to Development; Role of International Organizations

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