Expenditures for reproductive health and family planning services in Egypt and Sri Lanka

Type Report
Title Expenditures for reproductive health and family planning services in Egypt and Sri Lanka
Publication (Day/Month/Year) 2000
Publisher Policy Project
City Washington
Country/State DC
URL http://pdf.usaid.gov/pdf_docs/PNACL038.pdf
Using a national health accounts framework, comprehensive estimates of expenditures forreproductive health services and family planning in Egypt and Sri Lanka are derived. Thesecost estimates include the full costs of overheads and non-service delivery costs.Reproductive health service expenditures are defined as expenditures for family planning,prenatal and postnatal care, childbirth, infant care, and obstetric and gynecological services.In nominal terms, total expenditures were found to be $5.29 per capita in Egypt in 1994/95,and $3.10 in Sri Lanka in 1997. These expenditures are comparable, once standardized fordifferences in income levels, birth rates and women who are married, with expenditures inSri Lanka modestly less in per capita terms ($4.94 versus $5.29). The relative contributionof public and private sources of funding was quite similar in both countries. Public sources(which includes donor assistance) accounted for two-thirds of funding in both. Item-wise,family planning and MCH services accounted for the smallest share of costs (less than22%). The largest cost components were childbirth and general obstetric and gynecologicalcare, which accounted for a quarter and a third of total expenditures each. Generalgynecological care in both countries is predominantly privately financed, indicating a needto rethink policies to fully take into account private sector contributions. The similarity inspending levels in the two countries contrasts with the difference in levels of utilization andaccess to services. Sri Lanka achieves almost universal access to key services with lessexpenditures. This suggests that efficiency improvements may offer more potential forexpanding services than new resource mobilization.

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