Country case study on cost recovery in family planning. Egypt.

This report reviews and documents Egypts experience in cost recovery financing initiatives in the delivery of family planning (FP) services. The first chapter provides a rationale for cost recovery initiatives. Chapter 2 presents an overview of Egypts general health status child health status (giving neonatal postneonatal infant and child mortality rates) and socioeconomic and regional differences in maternal-child health status. The third chapter discusses the health sector with emphasis on the delivery of health services and the health care financing system (for total health care expenditures for relative expenditures on health services and for specific expenditures for FP). Chapter 4 investigates the role of the private sector in FP including the contribution of the private sector to the contraceptive prevalence rate and the estimated size of the potential private sector market. The fifth chapter describes the ongoing cost recovery financing program for FP services which includes the clinical services improvement project and the contraceptive social marketing project. The lessons learned are listed in Chapter 6 as follows: 1) a clear definition of the market segment enhances the development of an effective marketing strategy; 2) strict price controls are a disincentive for the increased involvement of the private sector; 3) successful cost-recovery projects depend upon proper design; and 4) profitability is adversely affected by inappropriate use of donor subsidies. The concluding chapter notes that the utilization of the private sector is nearly optimum but that private sector involvement depends upon donated contraceptives which reduces program sustainability.