Financial barriers may restrict women's ability to use their preferred contraceptive methods, especially long‐acting reversible contraceptives (LARC). Providing free access to a broad contraceptive method mix, including both LARC and short‐acting reversible contraceptives (SARC), may increase contraceptive use, meet women's various fertility needs, and increase their agency in contraceptive decisions. Linking facility and individual data from eight countries in sub‐Saharan Africa, we use a propensity score approach combined with machine learning techniques to examine how free access to a broad contraceptive method mix affects women's contraceptive choice. Free access to both LARC and SARC was associated with an increase of 3.2 percentage points (95 percent confidence interval: 0.006, 0.058) in the likelihood of contraceptive use, driven by greater use of SARC. Among contraceptive users, free access did not prompt women to switch to LARC and had no effect on contraceptive decision‐making. The price effects were larger among older and more educated women, but free access was associated with lower contraceptive use among adolescents. While free access to contraceptives is associated with a modest increase in contraceptive use for some women, removing user fees alone does not address all barriers women face, especially for the most vulnerable groups of women.

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免费获得广泛的避孕方法组合和妇女的避孕选择：来自撒哈拉以南非洲的证据

财务障碍可能会限制女性使用她们首选的避孕方法的能力，尤其是长效可逆避孕药 (LARC)。提供免费使用广泛的避孕方法组合，包括 LARC 和短效可逆避孕药 (SARC)，可能会增加避孕药具的使用，满足女性的各种生育需求，并增加她们在避孕决策中的代理权。将撒哈拉以南非洲八个国家的设施和个人数据联系起来，我们使用倾向评分方法结合机器学习技术来检查免费获得广泛的避孕方法组合如何影响女性的避孕选择。免费使用 LARC 和 SARC 与使用避孕药具的可能性增加 3.2 个百分点（95% 置信区间：0.006、0.058）相关，更多地使用 SARC。在避孕药使用者中，免费使用并没有促使女性改用 LARC，也对避孕决策没有影响。在年龄较大和受教育程度较高的女性中，价格影响更大，但免费使用与青少年避孕药具使用率较低有关。虽然免费获得避孕药具与一些女性避孕药具使用的适度增加有关，但仅取消使用费并不能解决女性面临的所有障碍，尤其是对于最脆弱的女性群体而言。