Politics of international development · Field lab · Week 7

Switched On, Switched Off

Every Republican president since 1984 has switched on the Mexico City Policy, and every Democrat has switched it off. While it's on, foreign NGOs that provide or even mention abortion lose all US funding. Pick a president and follow the switch from Washington to women living with violent partners.

Built on Heinzel, M. & Weaver, C. “Domestic Causes, Global Consequences: The US Mexico City Policy's Global Impact on Intimate Partner Violence.” International Studies Quarterly 69(3), sqaf049 (2025).

1 · Pick a president—

2 · Watch the clinics in an aid-dependent country48 clinics · schematic

full services cut back to stay safe lost family planning

—

3 · From a policy in Washington to violence at home

Try changing

US share of the country's family-planning money

Worldwide the US has paid for nearly half of all family-planning aid.

Other donors fill the gap

Below zero, other donors cut too, as under Bush II. Above zero, they make up some of the loss, as under Trump I. Each president sets the historical value.

Family-planning aid by president$M / yr

United Statesall other donors

01How do they know it's the policy?

The switch flips because of US elections, not because of anything happening in Kenya or Nepal. That makes it close to a natural experiment. The authors compare 139 low- and middle-income countries, 1993–2019, asking whether IPV burden rises in countries that get US health aid in the years the policy is on. Each model below adds a stricter check. The answer barely moves.

Extra deaths and disability from IPV while the policy is onDALYs per 100,000 women · Table 1

Reading the chart

DALYs (disability-adjusted life years) count years of life lost to early death plus years lived with disability.

Every estimate is between 209 and 305 extra DALYs per 100,000 women, about 16–27% more than average. All are significant at p<0.001. The bars show 95% confidence intervals.

Other checks: deaths alone show the same pattern. The effect is bigger for women of childbearing age, and it shows up under Bush II and Trump but not Obama.

02The argument

In three steps

1. Donor politics, not recipient politics. In the Kenya and Ghana labs, the politics that shaped aid happened inside the recipient country. Here the decision is made in Washington, along party lines, usually in a president's first days.

2. A narrow rule, a wide shock. One clinic may handle contraception, prenatal care and HIV testing. An NGO that refuses to certify loses all its US money. IPPF spent under 1% of its budget on abortion-related work and still lost about a quarter of its budget. NGOs that do certify often cut back further than the rule requires, just to be safe.

3. Violence follows. Women in abusive relationships are more likely to face unwanted pregnancies. Without access to care, they stay with abusive partners longer. The paper shows the country-level pattern. It does not trace individual women.

For discussion

Whose politics? Compare this with the Kenya and Ghana labs. Who can the women affected here hold accountable?
Other donors. Click Bush II, then Trump I. Why might other donors have cut alongside the US in 2001 but pushed back in 2017?
Natural experiment? Why does it matter that the switch is decided by US elections? What could still go wrong?
2025. The policy is back, along with deep cuts to US aid. If the US share of a country's family-planning money is already shrinking, does the policy matter more or less? Try it with the slider.