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Shared Decision-Making: Can Improved Counseling Increase Willingness to Pay for Modern Contraceptives?


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.

wp1094.pdf (1.35 MB)
Susan Athey
Katy Bergstrom
Vitor Hadad
Julian C. Jamison
Bert Özler
Luca Parisotto
Julius Dobhit Sama
Publication Date
September, 2021