Causes and consequences of teen childbearing: Evidence from a reproductive health intervention in South Africa

Type Journal Article - Journal of Health Economics 57 (2018) 221–235
Title Causes and consequences of teen childbearing: Evidence from a reproductive health intervention in South Africa
Author(s)
Issue 57
Publication (Day/Month/Year) 2018
Page numbers 221-235
Abstract
We use a natural experiment to estimate the causal impact of a public health intervention aimed atreducing teenage childbearing. The geographic and timing variation in the rollout of the South AfricanNational Adolescent Friendly Clinic Initiative (NAFCI) in the early 2000s provides a plausibly exogenousincrease in reproductive health knowledge and clinical access for teens. We investigate the causal path-way from the intervention’s initial impact on early-teen childbearing to subsequent consequences forlater-life outcomes of prime policy interest — education, employment and child health. Our empiricalstrategy uses GPS data from the National Income Dynamics Study to geolink women’s location of resi-dence during adolescence to the location and timing of the rollout. Our results show that living near aNAFCI clinic during adolescence delayed childbearing, substantially lowering the likelihood of early teenchildbearing. We estimate that adolescents who had access to NAFCI completed more years of school-ing and, consistent with increased human capital investments, earn substantially higher wages as youngadults. Finally, children born to women who had access to youth-friendly services as teens show substan-tial health advantages, indicating a strong intergenerational benefit of delaying early teen childbearingin a developing country context.

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