Contraceptive prevalence in Pakistan has plateaued near 34 percent for over a decade, suggesting that fertility levels are likely to stay high unless effective interventions are designed. We evaluate the Family Advancement for Life and Health 2007–2012 (FALAH), a family planning project implemented in 31 districts of Pakistan. Deviating from previous programs, FALAH emphasized birth spacing—as opposed to limiting family size—as the primary purpose of contraceptive use. We use Pakistan Demographic and Health Survey to evaluate FALAH's impact on continuous and binary measures of birth intervals. To estimate the causal effects of the project, we compare the outcomes for multiple children born to the same mother before and after the project. We find that FALAH increased interbirth intervals by 2.4 months on average and reduced the proportion of short birth intervals by approximately 7.1 percentage points. This finding suggests that birth spacing as a goal of contraceptive use may resonate better with Pakistani couples than limiting family size. The project's effects were more pronounced for women with high education, in rural areas, and in the middle of the wealth distribution.

中文翻译：

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从限制生育到生育间隔重新构建计划生育项目目标的效果：来自巴基斯坦的证据

十多年来，巴基斯坦的避孕普及率稳定在接近 34% 的水平，这表明除非设计出有效的干预措施，否则生育水平可能会保持高位。我们评估了 2007-2012 年家庭促进生命和健康 (FALAH)，这是一个在巴基斯坦 31 个地区实施的计划生育项目。与之前的计划不同，FALAH 强调生育间隔——而不是限制家庭规模——作为避孕药具使用的主要目的。我们使用巴基斯坦人口和健康调查来评估 FALAH 对出生间隔的连续和二元测量的影响。为了估计项目的因果效应，我们比较了项目前后同一母亲所生多个孩子的结果。我们发现 FALAH 将分娩间隔增加了 2 倍。平均 4 个月，将短生育间隔的比例降低了约 7.1 个百分点。这一发现表明，将生育间隔作为避孕使用的目标可能比限制家庭规模更能引起巴基斯坦夫妇的共鸣。该项目对受过高等教育的妇女、农村地区和处于财富分配中间的妇女的影响更为明显。