Family planning and fertility decline in rural Iran: the impact of rural health clinics

Abstract

During the first few years of the Islamic Revolution of 1979, and aided by pro‐natal government policies, Iranian fertility was on the rise. In a reversal of its population policy, in 1989, the government launched an ambitious and innovative family planning program aimed at rural families. By 2005, the program had covered more than 90% of the rural population and the average number of births per rural woman had declined to replacement level from about 8 births in the mid 1980s. In this paper, we evaluate the impact of a particular feature of the program – health houses – on rural fertility, taking advantage of the variation in the timing of their construction across the country. We use three different methods to obtain a range of estimates for the impact of health houses on village‐level fertility: difference‐in‐differences (DID), matching DID, and length of exposure. We find estimates of impact ranging from 4 to 20% of the decline in fertility during 1986–1996. Copyright © 2010 John Wiley & Sons, Ltd.