Causes and consequences of teen childbearing: Evidence from a reproductive health intervention in South Africa

Abstract

We use a natural experiment to estimate the causal impact of a public health intervention aimed at reducing teenage childbearing. The geographic and timing variation in the rollout of the South African National Adolescent Friendly Clinic Initiative (NAFCI) in the early 2000s provides a plausibly exogenous increase in reproductive health knowledge and clinical access for teens. We investigate the causal pathway from the intervention's initial impact on early-teen childbearing to subsequent consequences for later-life outcomes of prime policy interest - education, employment and child health. Our empirical strategy uses GPS data from the National Income Dynamics Study to geolink women's location of residence during adolescence to the location and timing of the rollout. Our results show that living near a NAFCI clinic during adolescence delayed childbearing, substantially lowering the likelihood of early teen childbearing. We estimate that adolescents who had access to NAFCI completed more years of schooling and, consistent with increased human capital investments, earn substantially higher wages as young adults. Finally, children born to women who had access to youth-friendly services as teens show substantial health advantages, indicating a strong intergenerational benefit of delaying early teen childbearing in a developing country context.

Birth Collapse and a Large‐Scale Access Intervention with Subdermal Contraceptive Implants

“…Improvement in the accessibility of contraceptive methods reduces economic and psychological costs for women, but evidence of empirical performance is mixed depending on the countries, methods, and selected outcomes (Branson and Byker 2018;Strupat 2017;Kagesten et al 2014;Ashcraft, Fernández-Val, and Lang 2013;Desai and Tarozzi 2011;Phillips, Bawah, and Binka 2006;Sinha 2005;Gertler and Molyneaux 1994). Despite the fact that there is no consensus in the evidence about the sign or the quantitative impact of contraceptive policies on teen births, there is evidence of the extensive and intensive rise in their use, as well as evidence of improvement in health outcomes (Bongaarts 2014;Cleland et al 2012).…”

The effects of teenage childbearing on education, physical health, and mental distress: evidence from Mexico

“…Using various balancing tests, we find 2 For example, in the context of developing countries, Ranchhod et al (2011) and Ardington et al (2015) show that teenage childbearing reduces education in South Africa using propensity score matching approach. Branson and Byker (2018) study a reproductive health intervention in South Africa and find that delaying teen childbearing increases schooling. no significant differences in the observable characteristics of treated (teenage mothers) and control groups after using inverse propensity score weights.…”

“… 2 For example, in the context of developing countries, Ranchhod et al (2011) and Ardington et al (2015) show that teenage childbearing reduces education in South Africa using propensity score matching approach. Branson and Byker (2018) study a reproductive health intervention in South Africa and find that delaying teen childbearing increases schooling.…”

Interventions for preventing unintended pregnancies among adolescents

“…[18] The long-term impact attributed to NAFCI is a lower likelihood of teen childbearing, enabling adolescents to complete more years of schooling and earn higher wages when they are young adults. [19] This exemplifies the potential for achieving 'triple dividend' with effective interventions to prevent unintended pregnancy during adolescence: better health and wellbeing during adolescence and adulthood, which will benefit the next generation. [20] Declaration.…”