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[Unpublished] . 10,  p.Based upon United Nations medium population projections, the population of developing countries will grow from 4,086 million in 1990, to 5,000 million by the year 2000. To meet this medium-level projection, 186 million contraceptive users must be added for a total 567 million in addition to increased contraceptive prevalence of 59% from 51%. This study estimates the number of contraceptive users, acceptors, and cost of contraceptive commodities needed to limit growth to this medium projection. Needs are estimated by country and method for 1990, 1995 and 2000, for medium, high, and low population projections. The number of contraceptive users required to reach replacement fertility is also calculated. Results are based upon the number of women aged 15-49, percent married, number married ages 15-49, and the proportion of couples using contraception. Estimation methodology is discussed in detail. Estimated users of respective methods in millions are 150 sterilizations, 333 IUD insertions, 663 injections, 7,589 cycles of pills, and 30,000 condoms. Estimated commodity costs will grow from $399 million in 1990 to $627 million in 2000, for a total $5.1 billion over the period. Pills will be the most expensive at $1.9 billion, followed by sterilizations at $1.4 billion, condoms $888 million, injectables $594 million, and IUDs $278 million. Estimated costs for commodities purchased in the U.S. show IUDs and condoms to be significantly more expensive, but pills as cheaper. With donors paying for approximately 25% of public sector commodity costs, developing country governments will need to pay $4.2 billion of total costs in the absence of increased commercial/private sector and donor support.
STUDIES IN FAMILY PLANNING. 1991 Jan-Feb; 22(1):1-18.A study investigative the pros and cons of financial payments for sterilizations to clients, medical personnel, and agents who motivate and refer clients was conducted by the government of Bangladesh in conjunction with the World Bank. Results indicate that Bangladeshi men and women opt to be sterilized both voluntarily and after consideration of the nature and implications of the procedure. Clients were also said to be knowledgeable of alternate methods of controlling fertility. A high degree of client satisfaction was noted overall with, however, 25% regret among those clients with less than 3 children. Money is a contributing factor in a large majority of cases, though dominating as motivation for a small minority. Financial payments to referrers have sparked a proliferation of many unofficial, self-employed agents, especially men recruiting male sterilization. Targeting especially poor potential clients, these agents focus upon sterilization at the expense of other fertility regulating methods, and tend to minimize the cons of the process. Examples of client cases and agents are included in the text along with discussion of implications from study findings.