Research

Breaking Barriers to Women's Reproductive Choice: Evidence from Online Pharmacies in India (draft coming soon)

Despite availability of modern contraceptives, high unmet need for such methods persists in developing countries, suggesting that barriers beyond access constrain women's reproductive choices. Social stigma around contraceptive procurement may prevent women from acting on existing preferences. This paper exploits the staggered expansion of e-pharmacies across Indian districts to test whether digital healthcare platforms that provide anonymity and doorstep delivery causally affect women's reproductive outcomes. Using a difference-in-differences framework, I find that e-pharmacy access generates a significant and persistent decline in abortions while producing only short-run decline in fertility. These impacts are concentrated in rural districts and districts with lower female literacy- settings where social constraints are most binding. Survey evidence reveals that e-pharmacy access increases contraceptive use to delay pregnancy and enables women to make contraceptive use decisions independently. Critically, contraceptive usage rises without corresponding changes in awareness of modern methods, indicating that information was not the binding constraint. Distance to physical pharmacies exhibits no relationship with online sales or reproductive outcomes, ruling out physical access as the operative channel. These findings demonstrate that privacy and autonomy rather than information or access, constitute the binding constraints on contraceptive use. The results highlight the potential for digital technologies to expand women's reproductive choice in settings where social stigma limits access to reproductive healthcare.

Strong IPR, Better Inclusion?  Impact of WTO Accession on Female AI Inventors in China (submitted)

with Sawan Rathi , Chirantan Chatterjee and Matthew J. Higgins 

NBER working paper 32547 

Do stronger intellectual property rights (IPR) incentivize women’s participation in innovation? We provide new causal evidence on this question using the USPTO’s Artificial Intelligence Patent Dataset. Our identification strategy exploits China’s WTO TRIPS accession, which led to a substantial strengthening of IPR in 2002. Our results show that post-WTO accession, the number of patents with at least one female inventor in China rose by 95%, and the number of individual female inventors increased by 111%, relative to other countries. We also find significant improvement in patent quality measured by forward citations, strategic importance, and patent impact scores. Heterogeneity analysis shows that gains were concentrated in less complex AI technologies such as computer vision and knowledge processing, with smaller increases in frontier areas like machine learning and evolutionary computation. Our results are robust to alternative control groups, synthetic controls, coarsened exact matching, and randomized inference tests. We identify three mechanisms underlying this surge in female innovation. First, the share of domestic female inventors on patenting teams rose sharply. Second, patents with female inventors increasingly originated from private firms rather than state-owned enterprises, reflecting market liberalization effects. Third, systematic investment in women’s higher education expanded the pool of qualified female researchers. Together, these findings suggest that while China’s WTO accession provided an exogenous policy shock, complementary institutional reforms were essential in enabling women’s participation in the innovation economy. Overall, the results highlight that stronger intellectual property rights when embedded in supportive institutional contexts can foster both technological progress and gender inclusion. 

Wage Changes and Women's Health Spending: Evidence from India (Revise & Resubmit, Oxford Open Economics) 

with Sambit Bhattacharyya , Chirantan Chatterjee and Somdeep Chatterjee 

Working paper series 1324, University of Sussex Business School 

In this paper, we explore the little studied role of gender-based tastes and preferences in the empirical relationship between income and demand for health care. Based on a large body of evidence which suggests that the gender identity of the recipient of money can significantly influence allocation of resources within the household, we conjecture that an increase in women’s income may have interesting and unconventional effects on demand for healthcare. Using data from a high-frequency large nationally representative household survey in India, we exploit exogenous variation in women’s take-home salary, generated by a change in the mandated rates of contribution to the employees’ provident fund, to estimate impacts on health care spending. We find that an unanticipated income shock is associated with a decrease in overall spending on healthcare in female led households even after controlling for improved health outcomes for women, health-status, healthcare utilization at the intensive margin (i.e., hospital visits to seek treatment). Our results suggest that healthcare spending by women in India and the global south is guided by dynamic preferences and social norms.

Resistance shocks and last-resort antibiotic use in urban India: A time-series analysis of pharmaceutical sales

with Manuel Hermosilla, Chirantan Chatterjee and Eili Y. Klein

Antimicrobial resistance is rising in South and Southeast Asia. When new resistance mechanisms are reported, prescribing and purchasing may shift towards last-resort drugs, accelerating resistance and raising costs. Evidence on these market responses is limited. We analysed quarterly IQVIA sales data for 10,767 anti-infective products sold in 30 Indian metropolitan areas from 2008–13. Products were classified using the WHO Access, Watch, and Reserve (AWaRe) framework, which groups antibiotics into first-line (Access), higher-resistancerisk (Watch), and last-resort (Reserve) categories. We estimated event-study models around early 2010 reports of New Delhi metallo-β-lactamase-1 (NDM-1), comparing Watch and Reserve products with Access products while controlling for product, city, and quarter fixed effects. The estimates show how Watch and Reserve outcomes changed relative to Access. Reserve quantities rose disproportionately after early 2010. Post-shock average Reserve quantities were about 1.9 times the pre-period baseline, versus roughly 1.2 times for Access and Watch products. Reserve price coefficients showed modest upward drift before 2010, but 95% confidence intervals included zero. By end-2013, Reserve quantities were about 0.4 log points higher relative to Access. Reserve prices more than tripled relative to baseline and increased relative to Access, with a temporary interruption around 2011–12 before the differential widened again. The paper shows that resistance shocks can increase both use and prices of last-resort antibiotics in private markets. The pattern is consistent with a demand surge into a thin Reserve segment with limited close substitutes and constrained short-run supply. Preparedness should combine rapid clinical guidance, stewardship, dispensing controls, and financing measures that protect access while conserving Reserve antibiotics.