This paper investigates whether family planning exposure mainly through the Lady Health Worker Program has had any effect on women’s fertility choices and use of reproductive health care service in rural Pakistan, using the 2013 Pakistan Demographic and Health Survey (PDHS). Exploiting variations in the program intensity across regions, we conduct instrumental variables (IV) estimation on the impact of family planning exposure on women’s fertility preferences and reproductive behaviors. Our analysis shows that even in the presence of strong son preferences in Pakistan, increasing family planning exposure reduces women’s incentive to have additional children. Moreover, family planning exposure is associated with more antenatal care visits, more deliveries performed by skilled professionals, and a greater chance of delivery at the health center. Finally, we examine the heterogeneity in the effect on fertility preference by age group and education level, and find that the effect is mainly significant for the educated and young women.

本文通过2013年巴基斯坦人口与健康调查（PDHS），调查了主要通过“夫人健康工作者计划”进行的计划生育接触是否对巴基斯坦农村地区妇女的生育选择和生殖健康服务的使用产生了影响。利用各地区计划强度的差异，我们对计划生育暴露对妇女的生育偏好和生殖行为的影响进行工具变量（IV）估计。我们的分析表明，即使在巴基斯坦有强烈的儿子偏爱的情况下，增加计划生育的覆盖面也会减少妇女生育额外孩子的动机。此外，计划生育暴露与更多的产前检查，熟练的专业人员进行更多分娩以及在卫生中心分娩的机会更大有关。