Family Planning and Economic Outcomes: Evidence from Outreaches in Remote Areas of Uganda

Improving access to contraception and essential healthcare services can significantly enhance health outcomes, and promote female labor force participation. However, unmet demand remains high. In rural Uganda, only half of the demand for family planning is met with modern methods, while over 35 percent of sexually active women have unmet needs and 44 percent of women cite distance to health facilities as a problem in accessing care. Adolescent mothers collectively forgo USD 15 billion in lifetime income—equivalent to 30 percent of annual GDP—due to unintended pregnancies. Health Access Connect is a Ugandan non-profit organization working with 98 health facilities across rural Uganda to facilitate monthly, financially self-sustainable outreach visits by clinical staff to rural communities that are located more than 5km from the nearest health facility. To date, each of these outreaches has served 5.6 family planning clients, provided 3.1 couple-years of protection, and promoted women’s agency and choice for their preferred method.  

The proposed randomized evaluation tests whether these outreaches affect women’s family planning decisions and subsequent labor market outcomes. The researchers answer two primary research questions: 1) how do rural health outreaches, and the associated health facility supply of commodities, impact uptake of family planning methods and method mix among reproductive-aged women, and 2) what is the impact of changes in access to contraceptives at health facilities on women’s labor market participation and labor force outcomes?