Purposive Program Placement and the Estimation of Family Planning Program Effects in Tanzania

Most studies evaluating the impact of family planning on fertility treat the presence of family planning clinics as being “randomly” assigned among the areas included in the study. They tend to ignore the possibility that the distribution of services may be related to the fertility level observed in a particular area. In some cases the distribution of services may respond to a conscious effort by public authorities or funding agencies to target areas with observed higher fertility. Even in absence of program planning, the factors determining service placement might be related to the determinants of high, or low, fertility in a particular area. If that is the case, and one fails to account for the endogeneity of family planning services, then the estimated impact of family planning programs will be biased. This article presents a modeling approach to address this issue. The model extends the simultaneous equation framework by integrating an individual-level model of timing and spacing of children ...