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Population Reports. Series J: Family Planning Programs. 1991 Nov; (39):1-31.This report discusses the challenges and costs involved in meeting the future needs for family planning in developing countries. Estimates of current expenditures for family planning go as high as $4.5 billion. According to a UNFPA report, developing country governments contribute 75% of the payments for family planning, with donor agencies contributing 15%, and users paying for 10%. Although current expenditures cover the needs of about 315 million couples of reproductive age in developing countries, this number of couples accounts for only 44% of all married women of reproductive age. Meeting all current contraceptive needs would require an additional $1 to $1.4 billion. By the year 2000, as many as 600 million couples could require family planning, costing as much as $11 billion a year. While the brunt of the responsibility for covering these costs will remain in the hand of governments and donor agencies (governments spend only 0.4% of their total budget on family planning and only 1% of all development assistance goes towards family planning), a wide array of approaches can be utilized to help meet costs. The report provides detailed discussions on the following approaches: 1) retail sales and fee-for-services providers, which involves an expanded role for the commercial sector and an increased emphasis on marketing; 2) 3rd-party coverage, which means paying for family planning service through social security institutions, insurance plans, etc.; 3) public-private collaboration (social marketing, employment-based services, etc.); 4) cost recovery, such as instituting fees in public and private nonprofit family planning clinics; and 5) improvements in efficiency.
Report of the Seminar on Programme Sustainability through Cost Recovery, Kuala Lumpur, Malaysia, 21-25 October, 1991.
London, England, IPPF, 1991. 15,  p.In the face of widespread user acceptance, rapidly growing demand, and developing country financial constraints, family planning associations must learn how to operate more efficiently and mobilize new resources with a view to ensuring greater long-term sustainability. Cost recovery was therefore identified as a means of maximizing the use of limited resources, improving program quality, strengthening management, and making service providers more accountable to clients. This document reports results from seminar participants organized to share the benefits of cost recovery with the international community, and to review policy and management issues. Reviewed in the seminar were country experiences with cost recovery, working group discussions on the definition of sustainability, the cost framework of family planning, determining user fees and clients' willingness to pay, preconditions for setting user fees, prerequisites for social marketing, models for cost sharing with the government and private sector, and country case studies from the Gambia, India, and Kenya. Those programs attaining highest self-sufficiency were aided by strong government commitment to either support family planning or to not impede program progress. Also helpful were a businesslike approach to service provision, a strong promotional campaign, organizational structure conductive to effective resource management, and resolve to try diverse approaches. In concluding, the importance of placing the customer first, cost-effectiveness, cost analysis, strategic planning, inter-FPA cooperation, and business plans are mentioned.
FRONT LINES. 1989 Dec; 6, 13.Projects supported by the Directorate for Population (S&T/POP) of the U.S. Agency for International Development and aimed at increasing for-profit private sector involvement in providing family planning services and products are described. Making products commercially available through social-marketing partnerships with the commercial sector, USAID has saved $1.1 million in commodity costs from Brazil, Dominican Republic, Ecuador, Indonesia, and Peru. Active private sector involvement benefits companies, consumers, and donors through increased corporate profits, healthier employees, improved consumer access at lower cost, and the possibility of sustained family planning programs. Moreover, private, for-profit companies will be able to meet service demands over the next 20 years where traditional government and donor agency sources would fail. Using employee surveys and cost-benefit analyses to demonstrate expected financial and health benefits for businesses and work forces, S&T/POP's Technical Information on Population for the Private Sector (TIPPS) project encourages private companies in developing countries to invest in family planning and maternal/child health care for their employees. 36 companies in 9 countries have responded thus far, which examples provided from Peru and Zimbabwe. The Enterprise program's objectives are also to increase the involvement of for-profit companies in delivering family planning services, and to improve the efficiency and effectiveness of private volunteer organizations in providing services. Projects have been started with mines, factories, banks, insurance companies, and parastatals in 27 countries, with examples cited from Ghana and Indonesia. Finally, the Social Marketing for Change project (SOMARC) builds demand and distributes low-cost contraceptives through commercial channels especially to low-income audiences. Partnerships have been initiated with the private sector in 17 developing countries, with examples provided from the Dominican Republic, Liberia and Ecuador. These projects have increased private sector involvement in family planning, thereby promoting service expansion at lower public sector cost.
Management information systems in maternal and child health / family planning programs: a multi-country analysis.
STUDIES IN FAMILY PLANNING. 1991 Jan-Feb; 22(1):19-30.Management and information systems (MIS) in maternal and child health were surveyed in 40 developing countries by trained consultants using a diagnostic instrument developed by UNFPA and the Pan American Health Organization (PAHO). The instrument covered indicators of input (physical infrastructure, personnel, training, finances, equipment, logistics), output (recipients of services, coverage, efficiency), quality, and impact, as well as frequency, timeliness and reliability of information. The consultants visited national and 2 provincial level administrative and service points of public and private agencies. Information on input was often lacking on numbers and locations of populations with access to services. In 15 countries data were lacking on personnel posts filled and training status. Logistics systems for equipment and supplies were inadequate in most areas except Asia, resulting in shortfalls of all types of materials and vehicles coinciding with idle supplies in warehouses. Financial reporting systems were present in only 13 countries. Service outputs were reported in terms of current users in 13 countries, but the proportion of couples covered was unknown in 25 countries. 2 countries had cost-effectiveness figures. Redundant forms duplicated efforts in half of the countries, while data were not broken down at the usable level of analysis for decision-making in most. Few African countries had either manual or computer capacity to handle all needed data. Family planning data especially was not available to draw the total picture. Often information was available too late to be useful, except in Portuguese speaking countries. Even when quality data existed, managers were frequently unaware of it. It is recommended that training and consultancies be provided for managers and that these types of surveys be repeated periodically.