<mark>to a FP clinic and the use of modern contraceptives compared to a control group with no differential effects between the two groups.</mark> Bellows et al. (2016) review voucher programs for FP in LMICs, which includes 16 studies, the majority of which were deemed by the authors to have low-quality designs. They find that vouchers, not surprisingly, generally increase contraceptive use. There were too few studies that reported changes in fertility, contraceptive (dis)continuation, or effects among adolescents.<sup>33</sup> Ashraf, Field, and Lee (2014) find at a large FP clinic in Lusaka, Zambia, that offering vouchers to married women (aged 18-40) alone leads to a higher take-up of injectables and leads to a 3-to-4-month delay in births compared with women who were offered vouchers in the presence of their husbands. However, the former group also reported lower levels of subjective well-being – possibly due to the psychosocial costs of using concealable contraceptive methods. Ashraf et al, (2020c), discussed below, found that informing husbands about maternal mortality risks led to reduced pregnancies and happier marriages. Thus, interventions that offer FP services to married women might consider incorporating information interventions for their husbands or partners.

Finally, it should be noted that vouchers play another important role in demand generation for modern contraceptive methods and FP services: while subsidies and reduced prices at facilities are adequate for clients of health care facilities, vouchers are also a convenient way to try to attract people counseled outside health care settings (such as home, school, workplace, or in their community). They introduce a management tool for interpersonal communication interventions at the community level, which gives visibility into the activities of community health (extension) workers and their success. In this way, vouchers help with the implementation fidelity issues of managing at scale this complex and expensive form of demand generation over and above their role in targeting subsidies.

# **A.2.4.** _Relaxing Information Constraints_

- _<u>Information on returns to education and academic performance:</u>_ the evidence of relaxing education information constraints on adolescent outcomes in developing countries is limited – especially for adolescent girls. The most promising results are likely that of Jensen (2012) (discussed above in section 3.1.3), who finds that providing parents and young women in rural India with information on job opportunities in the business process outsourcing industry led to an increase in schooling and postschool training, and an increase in both health and education investment in even younger girls in exposed villages. Similarly, Jensen (2010) and Nguyen (2008) both find positive effects on educational attainment when relaxing information constraints on the return to schooling, however the former investigates this only for boys in the Dominican Republic, while the latter investigates this only for primary school age children in Madagascar.

> 33 Cherewick (2017) also finds that vouchers promoted and distributed, sometimes door to door through communityawareness campaigns, in Cambodia, the Republic of Yemen, and Pakistan increased the take-up of LARCs. It should be noted, however, that causal identification in these studies is weaker than (quasi-) experimental studies – generally relying on before after comparisons without proper counterfactual comparison groups.

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