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    Family planning programme sustainability: a review of cost recovery approaches.

    Ashford LS; Bouzidi M

    London, England, International Planned Parenthood Federation [IPPF], 1992 Mar. iv, 81 p.

    Participants at the October 1991 IPPF seminar on Program Sustainability through Cost Recovery addressed the challenge of continuing to provide even more family planning (FP) services to the poorer segments of society while at the same time ensuring program survival. Field reports indicated a variety of funding sources, including user fees, social marketing programs, income generating schemes unrelated to FP, service agreements with the public sector, and private sources. Fees comprise the most common means of recovering FP program costs, but there is substantial diversity based on the income of the user, location of the service, and type of service provided. In view of field reports presented at the workshop, 6 broad recommendations were developed: 1) any approach to program sustainability must place the needs of the clients first; 2) sustainability should be an integral part of the organization's longterm strategic plan; 3) cost-effectiveness is a requirement; 4) periodic analyses of service costs, overhead costs, and costs per unit of output should be undertaken to monitor cost-effectiveness; 5) greater inter-IPPF cooperation and sharing of experiences should be encouraged; and 6) a business plan is essential for cost recovery. In countries where family planning acceptance is low and donor funds are available, FP associations are urged to focus on resource development rather than cost recovery from users. FP associations that provide health education services are encouraged to derive income from the sales of IEC materials or seminar fees. In some cases, higher fees can be charged for specialized services such as infertility counseling, but care must be taken to avoid diverting the program's emphasis from the primary task of managing the family planning program. The cost recovery schemes selected--fees, sales, insurance, or community fundraising--should always be consistent with the association's role in the national population program.
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