Source of maternal and child health care as an indicator of ability to pay for family planning

Context: Most developing countries cannot afford to provide free contraceptives to all women who choose to practice family planning. It is important to consider ways of determining which women need government subsidized services and which women can afford to pay for contraceptives. Methods: Demographic and Health Survey data from eight developing countries are used to determine the proportions of women with children aged five or younger who practice contraception and who purchase private health care for themselves or their children. By assuming that these women can also afford to purchase contraceptives, we estimate how the private sources of contraceptives and the government's family planning subsidies would be affected if all those who could afford to pay for their methods did so. Results: In three countries-Indonesia, the Philippines and Zimbabwe-if all women who purchased private maternal and child health care were to purchase their oral contraceptives from commercial sources, the private-sector share of the pill market would increase by 22-26%, while the government's financial burden for family planning would decrease by 3-7%. Conclusions: Encouraging women with the means to pay for private health care to purchase contraceptives from commercial sources could stimulate private sector participation, reduce the stress on overtaxed government family planning funding and allow substantially greater access to those in need of subsidized care