A randomized evaluation of scalable interventions to address factors causing fertility to exceed privately desired family size in Burkina Faso

Our study examines three factors that potentially cause families in Burkina Faso to exceed the privately desired family size that they express: contraceptive prices, misperceptions about the child mortality rate, and social norms in the community about family size. We do so via a randomized trial of scalable interventions in 500 villages. The first intervention addresses affordability by giving households free access to contraception at the local health clinic for 2 years. The anticipated child mortality rate is another factor that affects fertility; families sometimes have additional children to ensure they will have descendants and old-age support. Our preliminary research found that many people over-estimate the child mortality rate. Thus, a second intervention gives households accurate information about child mortality. Third, people report that having a large family confers social status in the community, yet they also say they want fewer children than is the current norm due to the expense of raising children. For example, they report that having fewer children would enable them to pay for school fees for all of their children. Social pressure to have large families may erode if enough people know that others also privately want smaller families. To test this hypothesis, we organize village debates about the pros and cons of larger versus smaller families and the role of social norms in influencing families’ fertility choices. Villagers vote anonymously on the motions that are debated, and the vote tallies are announced. We will measure the impacts of these interventions on the following primary outcomes: desired fertility, contraceptive use, and births.