Take up of the voucher was high at 47 percent, indicating that women valued the substantial reduction in the time cost of an appointment associated with the voucher.
However, evidence suggests that sharing information about family planning services with husbands reduces the couple’s propensity to utilize these services. Women who received the voucher in the presence of their husbands were 9 percentage points (18 percent) less likely to use the voucher to obtain an appointment at a family planning clinic. There is an even larger, 12 percentage point reduction in voucher use for couples where the husband reported wanting more children than the wife. Still a larger reduction in use is reported among younger couples, giving evidence for the hypothesis that differences in future preferences for fertility drive differences in demand for family planning services.
Male knowledge of the voucher led to a substantial reduction in use of these services, suggesting that policies or technologies that shift relative control of contraceptive methods from men to women may significantly increase contraceptive use and reduce average fertility in some contexts. This is important to note given that an increasing number of policymakers have started to promote “male involvement” in family planning. It also suggests that take up of particular modern contraceptive methods may be sensitive to the amount of control women can exercise relative to their husbands in the use of these methods.
1 Partners In Health, “Women’s Health – Reducing maternal mortality, improving reproductive health”, http://www.pih.org/issues/maternal.html. (Accessed September 21, 2009)
2 USAID, “Population, Health and Nutrition Issues in Zambia”, http://www.usaid.gov/zm/population/phn.htm. (Accessed September 21, 2009)
3 UNICEF, “Zambia Statistics”, http://www.unicef.org/infobycountry/zambia_statistics.html. (Accessed September 21, 2009)