Subsidizing birth control in Africa does nothing: Study

Melinda Gates is resigning from the Bill and Melinda Gates Foundation, a nonprofit organization funded by her husband’s billions, which exists primarily to get African women on birth control.

Getting poor women on birth control is the “cause of her life,” and her foundation is in the middle of spending $2.8 billion over a decade on this effort.

Maybe Melinda Gates’s successors at her foundation should read this latest study out of Burkina Faso, titled “The Negligible Effect of Free Contraception on Fertility.”

The researchers picked a random assortment of women to receive 100% vouchers for birth control and a second group to receive 10% vouchers. They found that the free birth control didn’t cause women to delay or avoid pregnancy.

Likewise, they provided educational seminars and village meetings about birth control, its efficacy, and its safety. The researchers found that only 20% worried about the safety of birth control, and yet most married women of childbearing age, including most such women who were offered free birth control, didn’t use it.

Why not?

My guess is that they wanted babies: “Desired fertility is high in the study population. Almost all women (92%) want another child, and 35% want a child in the next 2 years. Women report wanting a total of 6 children. There is little variation in the ideal number of children: half of women want 5 or 6.”

Note that in Burkina Faso, the total fertility rate is 4.6. That suggests Burkinabe women are falling short of their family-size goals rather than exceeding them.

Demographer Lyman Stone noted another telling detail about this study, involving the educational interventions:

Women were actually using the vouchers. That means the voucher was, in effect, just subsidizing families that were already using contraception. It’s hard to imagine why this would be a desirable way to distribute wealth to poor places.


Yes, birth control carries some stigma in Burkina Faso’s cultures. But notably, even among women who didn’t feel pressure to avoid birth control, the free contraception didn’t seem to affect birthrates.

Maybe in her new line of work, Melinda Gates can find something where her billions actually give people what they want.

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