Brown Bag Series
Can Contraceptive Uptake be Improved by Enhancing Access and Reducing Social Anxiety?
About the Speaker: Dr. Agha Ali Akram is an Assistant Professor in the Department of Economics at the Lahore University of Management Sciences. He received his Doctorate in Environmental Economics (2014) and Masters in Environmental Management (2008) from Yale University. Prior to joining LUMS, he was a Visiting Fellow at Yale University (2016-2017) and a Postdoctoral Fellow at Evidence Action (2014 - 2016), where his research delved into the impact of seasonal income support programs on mitigating hunger risk in Bangladesh and the impact of innovative conditional cash transfer mechanisms on improving vaccination rates in Pakistan. Dr. Ali’s research explores themes in public health including the quality of drinking water, mental health, nutrition and family planning. His work uses field experiments to test innovations in these research areas, both in Pakistan and abroad. His portfolio currently includes an experiment to improve youth mental health in Sierra Leone.
Abstract: Pakistan’s contraceptive uptake rate has stagnated while having the highest fertility numbers in South Asia (3.5 children per woman), which in part may be driven by low contraceptive uptake. What is the reason for this lack of demand? We postulate that behavioral biases are holding back the demand for contraceptives. Specifically, because people in Pakistan are not “trained” to buy condoms. The otherwise innocuous interaction required to buy condoms is difficult for customers in Pakistan due to which its demand is suppressed. We test our hypothesis using a randomized controlled trial in which our core intervention makes accessing condoms an event that induces less social anxiety through anonymized phone-based door-step delivery of condoms totally free. Our other main treatment arm provides shop-redeemable coupons (also free), to mimic business-as-usual condom procurement. We find, contrary to what we posited, that shop-redeemable coupons are more popular than the seemingly more discrete home delivery option. We hypothesize that this may be in part because our shop-coupon inadvertently “sanitized” the interaction at shops i.e. reduced the duration and intensity of the interaction with shopkeepers, for which we do see some evidence. Additionally, we find that home delivery of condoms is more popular among households with young women and men. This suggests diverging intergenerational preferences where younger people are more familiar with ordering at home.