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  • Behavioral Economics in Family Planning

Behavioral Economics in Family Planning

UPDATED - February 3, 2021

Successful development programs rely on people to behave in certain ways and make certain choices. Behavioral economics helps us understand why people behave and choose as they do, and behavioral design harnesses these insights for effective program development. 

Behavioral economics brings a unique perspective

For social and behavior change (SBC) professionals, understanding behavior is at the core of developing interventions to improve the lives of families and communities. Behavioral economics offers a unique perspective on behavior. Behavioral economics applies psychological insights to economic theories to help explain why people sometimes act in a way that is not consistent with their own preferences and stated intentions.1 It maintains the focus from standard economic theory on the institutions and contexts in which decisions are made, but incorporates insights from psychology to build a nuanced view of how people react to those contexts.2

Behavioral design harnesses insights about behavior to design solutions

 

Behavioral Design in Action

The (re)solve project, a collaboration between Pathfinder International, ideas42, Camber Collective, and the International Center for Research on Women funded by the Bill & Melinda Gates Foundation, employed behavioral design in Burkina Faso to create a suite of solutions to reduce unmet need for family planning services among adolescent girls. One component is a board game through which players face real-life relationship scenarios, make choices, “experience” the consequences, and share advice. The game elevates girls’ perceived risk of pregnancy; helps them to understand the personal, relational, and social trade-offs associated with an unintended pregnancy; and addresses concerns that hold girls back from accessing family planning services.5

Behavioral design brings a new tool to the SBC toolkit, harnessing insights from behavioral economics and other fields of research to design solutions that are attuned to the quirks of human behavior. The resources shared here offer several models for approaching behavioral design. One behavioral design model uses formative research to uncover the features of a person’s context—physical environment, past experiences, and interactions with others—that influence their choices and actions. It then applies those insights to programming through a participatory design process.3

Application to family planning

For people around the world, the ability to make choices about having children—whether to have them, when to have them, and how many to have—depends on a wide range of factors. Cultural norms, local health policies, identity, community dialogue, and individual method experience, to name a few, all shape how women and men think about family planning and use contraceptive methods. While global efforts have improved family planning and reproductive health (FP/RH) services, there are still many people who do not use these services even when they want to plan their families.  

Behavioral design has shown promise to develop innovative solutions to make FP/RH services more effective in responding to women’s needs.1 These solutions reshape the context in which women and families make choices about family planning and in which services are offered and support the use of FP/RH services that align more closely with families’ needs and goals.4

References

  1. Ashton et al. 2015. A Review of Behavioral Economics in Reproductive Health. Berkeley, CA, USA: Center for Effective Global Action. http://www.beri-research.org/wp-content/uploads/2015/01/BERI-White-Paper_version_1.20.15.pdf  
  2. Darling M, Datta S, & Mullainathan S. 2013. The Nature of the BEast: What Behavioral Economics Is Not. Center For Global Development. https://www.cgdev.org/publication/nature-beast-what-behavioral-economics-not 
  3. Tantia P et al. 2019. Changing Behavior to Improve People’s Lives: A practical guide [Internet]. New York, NY: ideas42. https://www.ideas42.org/wp-content/uploads/2020/02/I42-1152_ChangingBehaviorPaper_3-FINAL.pdf
  4. Family Planning and Reproductive Health. ideas42. https://www.ideas42.org/blog/project/fprh/
  5. (re)imagining contraceptive services: (re)solve in Burkina Faso. Pathfinder International. https://www.pathfinder.org/publications/reimagining-contraceptive-services-resolve-in-burkina-faso/

 

Banner photo: Women from a Young Mothers Group in Uganda meeting and getting family planning information from a community health worker. The program is supported by Reproductive Health Uganda, with the goal to empower the women in the group, and provide them with family planning information. License: Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Learn more

 

Resources

  • Tools
  • Examples

Behavioral Design Checklists

Behavioral design checklists can help a one discover in minutes if a program, product or service is designed for how people really behave—and find proven tactics for improvement. It is suggested that these checklists be utilized to ensure that programs are optimized for success.

View Resource

Behavioral Design Toolkit

The goal of this toolkit module is to help the user solve product design problems.

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Changing Behavior to Improve People’s Lives

This essay focuses on the role of behavior change in improving individual and social outcomes. Our framework is based on the work of ideas42—an organization that uses insights from behavioral science to design scalable solutions for social impact.  

View Resource

Five Learnings in Behavioral Science

Busara is an instiution which seek to better understand the levers of behavior change.

View Resource

Improving the Uptake and Adherence of Iron Folic Acid Supplements among Pregnant and Lactating Women

Busara carried out a study in India among 1,150 participants in partnership with the Centre for Social and Behavioural Change. The study worked on narrowing down and refining interventions aimed at driving uptake and adherence of Iron Folic Acid pills among pregnant and lactating women.

View Resource

The (re)solve Project

Launched in 2016, (re)solve is a four-year project funded by the Bill & Melinda Gates Foundation. It is led by Pathfinder International in partnership with Camber Collective, The International Center for Women, and ideas42, and is active in Bangladesh, Burkina Faso, and Ethiopia.

View Resource

Handoff Package for Postpartum Family Planning and Improved Counselling

Malawi

This document provides an overview of a provider behavior change solution set, and is intended to encourage ownership and scale-up of the solution set by local partners in Malawi.

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Encouraging Family Planning Counseling that Promotes Meaningful Choice

Malawi

Despite recent gains in the use of modern contraceptives around the world, many women are still dissatisfied with their family planning methods and discontinuation remains high.

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New Game for Ugandan Men Uncovers Behavioral Barriers to Family Planning

Uganda

Uganda has a high fertility rate and a declining mortality rate, resulting in rapid population growth. This has led to a dependent population that is not conducive to economic production, savings, investment, or development.

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Judging the Nudge: Applying Behavioral Economics to Promote Post-Abortion Family Planning in Nepal

Nepal

Studies show that half of all pregnancies in Nepal are unintended, and almost half of these are with women using some sort of contraception. Women attending MSI clinics in the country say they want to delay their next pregnancy but contraception use after abortion has remained low.

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Encouraging Counseling that Promotes Meaningful Choice: Behavioral Design for Provider Behavior Change in Family Planning Services in Malawi

Malawi

The project conducted formative research to systematically define a behavioral problem, drawing from health facility observations, interviews with key stakeholders, and discussions with partners. These insights led Breakthrough ACTION to develop the following behavioral problem statement: Providers do not counsel postpartum women on the full range of contraceptive methods in a way that women internalize. We want providers to consistently provide comprehensive FP counseling that resonates with their clients.

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Improving Youth Sexual and Reproductive Health in Senegal

Senegal

Together, IntraHealth International and the Ministry of Health and Social Action in Senegal, as part of the Neema project which aims to improve health for women and children in Senegal by strengthening health services and making them accessible to more people, we identified behavioral barriers to using contraception and designed solutions to help young people make active decisions about their sexual health.

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Integrated Family Planning and Immunization Services in Senegal

Senegal

While many Senegalese mothers visit health facilities to immunize their newborns, far fewer discuss family planning options with a health worker. Integrating family planning counseling into immunization services is a promising practice to address reproductive health needs in the extended postpartum period. A project supported by Ideas42 and IntraHealth developed a behaviorally informed model that integrates these two services to help more women access the family planning option that is right for them.

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In-Kind Incentives and Health Worker Performance in El Salvador

El Salvador

In this project in El Salvador, public sector community health teams were awarded points for targets met on maternal and child health outcomes. Targets were measured at baseline and every six months for the next 18 months, and points were redeemable for in-kind incentives like computers and air conditioners to be shared in the workplace.

View Resource
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Stephanie Levy
Emily Zimmerman
Elizabeth McElwee

This website is made possible by the support of the American People through the United States Agency for International Development (USAID) under the Breakthrough-ACTION Project, supported by USAID’s Office of Population and Reproductive Health, Bureau for Global Health, under Cooperative Agreement #AID-OAA-A-17-00017 with the Johns Hopkins University.

Breakthrough-ACTION is based at the Johns Hopkins Bloomberg School of Public Health’s Center for Communication Programs (JHU∙CCP). The contents of this website are the sole responsibility of JHU∙CCP. The information provided on this website is not official U.S. Government information and does not necessarily represent the views or positions of USAID, the United States Government, or The Johns Hopkins University.

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