Background: Unmet need for family planning and unintended pregnancies are high in developing countries. Homepregnancy tests help women determine their pregnancy status earlier and the confirmation of a negative pregnancystatus can facilitate the adoption of family planning. This study provides the first experimental evidence of the effectof access to pregnancy tests on womenâs demand for modern family planning.Methods: A randomized controlled trial was conducted among 810 women of reproductive age in northernUganda. During a baseline survey, women were randomly allocated to either: (1) an offer to take a hCG urine pregnancytest during the survey (on-the-spot pregnancy test) (N = 170), (2) an offer of a home pregnancy test kit tobe used at any time in the future (future-use pregnancy test) (N = 163), (3) offers of both on-the-spot and future-usepregnancy tests (N = 153), or (4) a control group (N = 324). Future-use pregnancy tests were offered either for free, orrandomly assigned prices. Approximately 4 weeks after the baseline survey, a follow-up survey was conducted; moderncontraception methods were made available at no charge at local community outreach centers.Results: When offered a free, on-the-spot pregnancy test, 62 percent of women accepted (N = 200). Almost all, 97percent (N = 69), of women offered a free future-use pregnancy test strip, accepted it. Purchases of future-use pregnancytests declined with price. The offer of either on-the-spot, future-use tests, or both, have no overall large or statisticallysignificant effects on the take-up of modern family planning.Conclusion: Demand for pregnancy tests is high and access to pregnancy tests has the potential to facilitate thedemand for family planning. At the same time, more research is needed to understand underlying beliefs about pregnancystatus and risk that guide behaviors ultimately important for maternal and neonatal health.Trial registration The study was pre-registered in July 2018 for AEA RCT registry (AEARCTR-0003187) and clinicaltrials.gov (NCT03975933). Registered 05 June 2019, https:// clini caltr ials. gov/ ct2/ show/ record/ NCT03 975933Keywords: Pregnancy tests, Family planning, Unmet needs of contraception, Randomized controlled trial, UgandaPlain Language SummaryWomen in developing countries, especially in Africa, have high-unmet needs for family planning as well as highunintendedrates of pregnancy. At the same time, they may learn their pregnancy status later than women in higherincomecountries due to irregular menstrual periods, malnutrition, or limited access to home pregnancy tests. Better
