Costs of contraceptive social marketing programs implemented through the SOMARC [social marketing for change] project

These projects are designed to expand the availability of affordable contraception to couples who want to plan their families. The present study, an update of similar studies conducted in 1992 and 1995, examines the costs of USAID-funded CSM programs in 29 countries. A country had to have at least 2 years of sales and a majority of costs flowing through the SOMARC project to be included. General conclusions are as follows: (1) The costs of SOMARC"s CSM marketing projects are substantially below average costs for other modes of service delivery. In 1996, the average cost per couple-year-of-protection (CYP) was $5.31. The cumulative cost for all program years and all country projects is only $6.83 per CYP. When project overhead costs are added to country-specific costs, the annual cost-per-CYP in 1996 becomes $6.37 and the cumulative for all years becomes $8.18 -- in contrast to the $15-20 per CYP often reckoned by USAID for all modes of service delivery. (2) Cost per CYP declines dramatically with the duration of the project as initial investments in market research and project design begin to pay off. The average first year cost is $19.88 per CYP, but this drops to an average of $4.82 per CYP by the seventh year and to just $0.54 per CYP for the one project that has been ongoing for 12 years. Costs also vary by implementation model. For example, the average cost in the seventh year for all projects using donated commodities is $11.64, while the average for those using commercially purchased commodities is just $4.07 per CYP. (3) Several SOMARC projects have achieved complete self-sufficiency and are now providing services to clients with no additional public subsidy.