Shared Decision-Making
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World Bank, Washington, DC
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Long-acting reversible contraceptives
are highly effective in preventing unintended pregnancies,
but take-up remains low. This paper analyzes a randomized
controlled trial of interventions addressing two barriers to
long-acting reversible contraceptive adoption, credit, and
informational constraints. The study offered discounts to
the clients of a women’s hospital in Yaoundé, Cameroon, and
cross-randomized a counseling strategy that encourages
shared decision-making using a tablet-based app that ranks
modern methods. Discounts increased uptake by 50 percent,
with larger effects for adolescents. Shared decision-making
tripled the share of clients adopting a long-acting
reversible contraceptive at full price, from 11 to 35
percent, and discounts had no incremental impact in this group.
Palabras clave
FAMILY PLANNING, FERTILITY, LONG-ACTING REVERSIBLE CONTRACEPTIVE, HETEROGENOUS TREATMENT EFFECT, COUNSELING