Case study of contraceptive self-reliance efforts in Turkey : prospects and lessons learned

Since 1995, USAID, working primarily through the OPTIONS II and the POLICY projects, has provided TA to help the GOT respond to the phase-out of U.S. contraceptive supplies scheduled for completion in 2000 and achieve contraceptive self-reliance. This case study documents this process. Section II describes the national family planning program, the phase-out, and the context into which this phase-out has occurred. Section III describes key participants and stakeholders in the phase-out process. Section IV describes technical activities implemented since 1995 to respond to the phase-out. The impact and shortcomings of these activities are also described, using information gathered from case study key informants. Section V assesses where the national program stands now, as well as program prospects and challenges as Turkey enters the era of complete self-reliance. This section also draws heavily on responses from case study key informants, lays out several key lessons learned regarding the phase-out process, and provides recommendations for action within Turkey"s national family planning program. The principal finding is that Turkey has made considerable progress toward contraceptive self-reliance. Some components of a self-reliance strategy are falling into place, and there is broad consensus about the remaining components. Still, the process of shifting away from a donor-supplied program is not yet complete. Given the economic and political context in which this phase-out has occurred and the relatively short period of time Turkey has had to plan its response, the progress witnessed is commendable. Although the milestones achieved provide much to be proud of, many stakeholders in Turkey are mindful of the need for continued high- level attention to self-reliance activities. The GOT spent an increasing amount of money replacing donated contraceptives, but a sizeable gap remains. Progress has also been made toward implementing alternative financing strategies, such as targeting and cost recovery, to place the public sector program on a sustainable footing; Turkey is preparing to pilot test and implement those strategies. (Author abstract, modified)