Impact of Free Pregnancy Test Kits on Family Planning Use: Evidence from a Randomized Experiment in Madagascar

Alison B. Comfort, Abt Associates
Slavea Chankova, Abt Associates
Randall Juras, Abt Associates
Natasha Hsi, Management Sciences for Health
Lauren Peterson, Abt Associates
Payal Hathi, Research Institute for Compassionate Economics (r.i.c.e.)

Many countries in sub-Saharan Africa use community health workers (CHWs) to increase access to contraceptives. Before they can provide hormonal contraceptives to clients, CHWs use a pregnancy checklist, a series of questions that allows CHWs to assess whether a woman is pregnant. However, CHWs may not trust the checklist and it categorizes many non-pregnant women as pregnant. This study assesses the impact of offering free pregnancy test kits to CHWs on the number of clients that they supply hormonal contraceptives to. Using a randomized-controlled design, we randomly selected some CHWs in three regions in Madagascar to either receive pregnancy tests kits (treatment) or not (control). This intervention increased the number of new hormonal contraceptive clients per CHW by 0.6 clients per month, representing a 24% increase. This intervention provides evidence that offering pregnancy test kits is a promising approach to increase adoption of hormonal contraceptives.