| Autor: |
Karen Johnson Lassner, Timothy Williams, Lynn Bakamjian, Jeanne M. Haws |
| Rok vydání: |
1992 |
| Předmět: |
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| Zdroj: |
Studies in Family Planning. 23:85 |
| ISSN: |
0039-3665 |
| DOI: |
10.2307/1966538 |
| Popis: |
The objective of this 1989-90 policy impact study of sterilization services was to review how access and quality were affected by the decreases or withdrawal of subsidies and general decline in financial support for sterilization programs in Brazil the Dominican Republic and Mexico. The focus is on cost-recovery strategies used by nongovernmental organization (NGOs) when faced with reduced donor support from the Association for Voluntary Surgical Contraception (AVSC). 4 recommendation are provided. In the brief background discussion there is reference to the following findings: there are few differences in demand between free and moderately priced FP services; user fees rarely cover all costs; wide variation exists in estimating cost methodologies; and sliding fee scales are difficult to administer. Questionnaire on financing and service statistics client profiles alternative service sites and referral for services were obtained from clinic staff. The findings were that there was a sharp decline in caseload at 14 of the 20 sites examined. 4 sites at least 1 in each country had an increased caseload; 1 had no change and 1 had a decrease due to management policy to do so. These 6 reflect strategies for continuance of the program and self-reliance. Of the 17 clinics which responded with an increase in fees only 3 did not have a decline in caseload. There was same evidence that increased fees brought more middle income clients. Successful strategies included securing other funding and diversifying services. In locations where other low or no cost services were available most clinics increasing fees lost clients. Recommendations identified the following elements for sustainability: 1) the need for careful planning 2) the ability to identify costs and set elastic fees 3) the existence of an entrepreneurial spirit that guides organization effort in seeking alternative funding sources and 4) diversification of services. There was proof at some sites that sustainability was compatible with accessibility with the condition that self-reliance is planned for and other than fee increasing strategies are employed. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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